2018 Wheelworks Multisport Application
Please fill out the application completely whether you are a new or returning member. Once you have submitted the application please pay via the link at the bottom of this page or on the confirmation page. Any questions about the application please contact
Identify whether you are a new or returning member
Preferred Telephone Number
example: (XXX) XXX-XXXX
In case of emergency, please notify:
(This information will be shared with other teammates to be used for emergencies only)
Emergency Contact Name
Emergency Contact Telephone
example: (XXX) XXX-XXXX
USAT Membership Information
For insurance purposes, you MUST have an unexpired USAT number. Please visit
for more information.
USAT Member # (MANDATORY)
If you're a new member, how did you hear about the team?
From a Wheelworks store
Saw the team at an event
Word of mouth
Tell us about yourself
For example: How did you become interested in triathlon? What's your strongest leg/favorite race/workout/training spot? Any other hobbies or interests? This will be viewable by team members within our Google Groups member area. You may update or elect to remove your bio at any time.
What size t-shirt do you wear?
What gender of t-shirt do you wear?
Please list any recent races you have done (triathlons and other disciplines):
Returning members must list a minimum of three races completed in the past year.
My goal distance for this season is:
To finish my first triathlon
Where do you train? (Select all that apply)
By selecting one or more of the locations, you agree to have your training neighborhood(s) listed for other WWMS members to see
West of Boston
Are you interested in partnering with being a mentor for a team member who is trying out their first sprint, olympic, half or full ironman? Or are you interested in partnering with a current team member who has experience racing your goal distance for this season?
Mentor (I would like to be a mentor to someone)
Mentee (I would like to be paired with a mentor)
Mentorship Program Comments
Mentors please identify which disciplines and/or distances you are most familiar with. Mentees identify what you are looking for in a mentor. Please include any information you feel will help us better match you.
Do you maintain a training blog? Let us know the address and we'll link to you from the team website.
Training blog comments
Feel free to enter a short description.
Please read the following Waiver and acknowledge below:
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT ("AGREEMENT")
IN CONSIDERATION of being permitted to participate in any way in any Wheelworks Multisport team event ("Activity") at any time during the current calendar year I, for myself, my personal representatives, assigns, heirs, and next of kin:
1. ACKNOWLEDGE, agree, and represent that I understand the nature of the Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further agree and warrant that if, at any time, I believe the conditions to be unsafe, I will immediately discontinue further participation in the Activity.
2. FULLY UNDERSTAND that:
(a) THIS ACTIVITY INVOLVES RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("Risks");
(b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the conditions in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW;
(c) there may be OTHER RISKS or SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the Activity.
3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE Wheelworks Multisport, their administrators, directors, agents, officers, members, volunteers, and other participants, officials, rescue personnel, sponsors, advertisers, owners and lessees of Premises on which the Activity is conducted, (each of the forgoing shall be considered one of the RELEASEES herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED, OR ALLEGED TO BE CAUSED, IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may be incurred as the result of such claim.
I ACKNOWLEDGE THAT I AM OVER THE AGE OF 18 YEARS, HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS, AND HAVE AGREED TO IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE, AND I INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
Please read and acknowledge the following team Code of Conduct agreement:
Wheelworks Multisport strives to create a safe and supportive environment for our members to train and race. Please remember that while racing, participating in team events and while wearing the team uniform or Wheelworks Multisport logo that you are representing both the team and the Belmont/Ace Wheelworks store. As a teammate you agree to:
- Respect all participants regardless of age, gender, sexual orientation, cultural background, religion, political persuasion or athletic ability.
- Refrain from unsportsmanlike conduct, including, but not limited to - foul language, verbal abuse or inappropriate gestures towards referees, race staff, volunteers, other athletes or spectators.
- Show respect for the safety and well being of others.
- Encourage and support other teammates.
- Agree to abide by rules set by USAT and the race directors while racing and follow the rules of the road.
By signing this agreement you agree to wear the Wheelworks Multisport team uniform while racing in multisport events. The uniform consists of the one piece team tri kit or the team tri top and your choice of tri shorts. Purchasing the uniform is mandatory for new members. You will also refrain from sharing sponsor discounts and race discounts with non-teammates. Codes are not to be shared or posted on social media.
Calls for race volunteers will be sent out via the email listserv. While we do not require a minimum amount of volunteer time, we strongly encourage members to volunteer whenever possible. By supplying enough volunteers for certain races, we are sometimes able to earn money for the team. Providing volunteers reflects positively on our organization, creates camaraderie and is a great way to give back to the sport. We may also call on volunteers to help support team events and training.
Failure to abide by these guidelines may result in suspension or revocation of membership in Wheelworks Multisport.
Sponsorship and volunteering
I have read and agree to the stated terms regarding volunteering and sponsorship
Electronic Signature (please print your name)
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