North Carolina Junior (13-19) Cycling and Triathlon Team by Triangle Multisport

    2014 Registration Form

    Open to athletes ages 13-19, the team incorporates both a development and competitive team for a fun and team-oriented environment.

    Please list the full name and birthdate of each participant below

    You may list more than one child if applicable.
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    Please list the name of the school that each participant attends

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    Please fill out any relevant medical history information for each participant

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    Please fill in the sports history for each participant

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    Please list each participant's USAT Member Number

    All participants will need to become USAT (USA Triathlon) members before the second practice of the season. Please go to http://usatriathlon.org and click on "Become a member today!" in the upper right-hand corner of the website.
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    Parent/Guardian Information

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    Athlete Acknowledgement of Risk and Liability

    1. I am applying for my child to participate in the Triangle Multisport Triathlon Team athletic training program and related activities (collectively “Training”) being fully aware that the Training involves risks. I accept all the risks of my child participating in the Training. Risks of the training include, without limitation, risks of bicycling, running, swimming, triathlon, duathlon, physical exertion, training and competing in large groups of people in which a person may be knocked down and fallen on, motor vehicles, and road and surface conditions. Additional risks are described on the accompanying List of Possible Hazards. I accept and acknowledge the existence of additional, unlisted risks. 2. I fully release, discharge, and waive any Claims I may have, now or in the future, against Triangle Multisport, even if Claims are based on the carelessness or negligence of a Released Party or anyone else. ("Claims" as used in this document means any and all liabilities, claims, demands, legal actions, and rights of action for damages, personal injury, or death that are related to or in any way connected with my participation in the Training that I or my heirs or personal representative could make. "Released Parties" as used in this document means Triangle Multisport Triathlon Team, its Managers, Members, Officers, Employees, Consultants and Agents, Coaches, Associate Coaches and Employees, and Agents of Associate Coaches.) 3. I agree to indemnify (reimburse for any loss) and hold harmless Triangle Multisport from any loss or liability (including any reasonable attorneys fees they may incur) defending any Claim made by me or by anyone making a Claim on my behalf, even if the Claim is alleged to result from the carelessness or negligence of Triangle Multisport or anyone else. 4. I am aware that there is no obligation for any person to provide my child with medical care during the Training. If medical care is rendered to my child, I consent to that care if I am unable to give my consent in person for any reason at the time that the care is rendered. I am aware that it is advisable to consult a physician prior to participating in the Training. If I have consulted one, I have taken the physician's advice. 5. I grant my permission to Triangle Multisport to utilize any photographs, motion pictures, videotapes, recordings, or any other references or records of the Training that may depict, record, or refer to my child for any purpose, including commercial use, by Triangle Multisport, as long as the child’s name is not published. 6. I agree to abide by the rules of Triangle Multisport in any of its training sessions. I acknowledge that, if my child violates any of these rules, they may be removed from the training session and the permission for them to participate in the Training session may be withdrawn by representatives of Triangle Multisport. Others may violate the rules of the sessions, adding to the risks of participation. 7. I intend that this document act as the broadest and most inclusive assumption of risk, waiver, release of liability, agreement not to sue, and indemnity as is permitted by the laws of North Carolina. If any portion of it is held to be invalid, I agree that the rest of it shall continue in full force and effect. The singular of nouns and pronouns in this document includes the plural and the plural includes the singular. I agree that this agreement was made in North Carolina, and that the laws of North Carolina shall govern its interpretation and enforcement. 8. As the participant is under 18 years of age, the parent agrees to the previous and following statements: As a parent or guardian of the participant, I authorize the child to participate. I also join in the statements and agreements made by the participant in this document. I agree that, in the event participant or anyone acting on his or her behalf should make any Claims, I will provide the indemnities described in paragraph 3.


    List of Possible Hazards

    The following is a partial list of hazards that are often associated with training for triathlon, duathlon, bicycle racing, running, swimming, cross country skiing, and other such endurance events: • Falls resulting in broken bones, sprains, strains, contusions, and equipment damage. • Collisions with other athletes or vehicles on the road or trail. • Drowning during open water swimming. • Saddle sores, crotch rash, neck and back pain, and hand numbness related to bicycle riding. • Tendonitis and bursitis, muscle strains and/or tears, and trigger points. • Upper respiratory infections associated with heavy training loads. • Heart attack and other heart-related symptoms. • Gastrointestinal problems such as diarrhea and constipation (due to dehydration issues) • Blood in urine, issues trying to urinate, and high ketones or protein levels. • Men: penile numbness, prostatitis, swollen testicles, and impotence from bicycling. • Women: nipple pain from friction, vulvar swelling, groin and chest rashes, and yeast infections. • Anemia, fatigue, difficulty sleeping, and exposure to pollution, weight loss, and immune system issues due to improper recovery and nutritional needs. • Post-goal race depression – common after your "A" race for the season. • Reactions to chlorine, possible ear infections, excessive dry skin (worse in cold climates), change in hair color, and nasal infections.

    Participant Signature(s)

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    Parent/Guardian Signature(s)

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    Thanks for filling out the Triangle Multisport Triathlon Team Registration Form for the Spring 2014 Season. Please click "Submit" below to finish registering.