Roaring Fork Women's Triathlon Team Application & Data Sheet 2017
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First Name
Your answer
Last Name
Your answer
Address
Your answer
City
Your answer
Zip Code
Your answer
Cell Phone
Your answer
Home Phone
Your answer
Work Phone
Your answer
Email
Your answer
Age
Your answer
Birthdate
MM
/
DD
/
YYYY
Occupation
Your answer
Days I work
Your answer
Physician's Name
Your answer
Date of last heart and lung exam
MM
/
DD
/
YYYY
Emergency Contact's Name
Your answer
Emergency Contact's Phone Number
Your answer
T-shirt Size
Sock Size
Shoe Size
Your answer
Height
Your answer
Weight
Your answer
I work out...
I have a health challenge, yes or no.
If you answered "Yes" above, please explain.
Your answer
Swim experience: Triathlon training requires basic freestyle swim skills. How well can you swim? See Swim Questionnaire and also answer the following:
Bike Experience:
What type of bike do you prefer?
Walk Experience (if you will RUN, skip this section)
Run Experience (if you will WALK, skip this section)
5K Experience
If you've completed a 5K, what was your best time?
Your answer
Triathlon Experience:
If you've completed multiple triathlons, please give the numbers of each distance you've completed. (Example: 5 sprints, 1 olympic):
Your answer
Please explain why you want to take this triathlon training class:
Your answer
Membership: please check applicable option below (Payable in full via www.active.com)
Required
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