29th ANNUAL BARBADOS NATIONAL TRIATHLON 2019 - ENTRY FORM
THE BARBADOS FEDERATION OF ISLAND TRIATHLETES "BFIT" OFFICIAL ENTRY FORM
PLEASE PRINT ON THE FORM & READ CAREFULLY BEFORE SIGNING THE WAIVER AND RELEASE:
In consideration of the acceptance of my entry, I/we for my/our heirs, executors and administrators, release and forever discharge all sponsors and THE BARBADOS FEDERATION OF ISLAND TRIATHLETES (BFIT), the parish, country or district where these events are held and all sponsors, producers, their agents, representatives, successors and assigns, of all liabilities, claims, actions, damages, costs and expenses which I/we may have against them arising out of or in any way connected with my/our participation in these events, including travel to and from these events, and including all injuries that may be suffered by me/us before, during, or after the events. I/we understand that this waiver includes any claims based on negligence, action or inaction of any of the above parties. I/we recognize the difficulties of these events and attest that I/we am/are sufficiently physically fit to compete safely in these or other events and that I/we have not been advised otherwise by a qualified medical person. I/we give consent to receive medical treatment during these events and assume the risks of competing. I/we understand that I/we may be photographed, taped or filmed during these events and I/we allow my/our photo(s), video or film likeness and/or my voice to be used for any legitimate purpose by the producers or sponsors.
________________________________________
29th ANNUAL BARBADOS NATIONAL TRIATHLON 2019
EVENT DATE: 13th October, 2019, 6:00 a.m. Location: Spring Garden Hwy

ENTRY FEES FOR BARBADOS RESIDENTS:
Early Bird 1 (Before June 30th, 2019)
Olympic distance – members BBD $100 or USD $50, non members BBD $120 or US $60
Sprint distance – members BBD $90 or USD $45, non members BBD $110 or US $55
Sprint relay (3 person team) - BBD $120 or USD $60 (per team)

Early Bird 2 (Before August 31st, 2019)
Olympic distance – members BBD $110 or USD $55, non members BBD $130 or US $65
Sprint distance – members BBD $100 or USD $50, non members BBD $120 or US $60
Sprint relay (3 person team) - BBD $130 or USD $65 (per team)

After August 31st, 2019
Olympic distance – members BBD $130 or USD $65, non members BBD $160 or US $80
Sprint distance – members BBD $120 or USD $60, non members BBD $140 or US $70
Sprint relay (3 person team) - BBD $150 or USD $75 (per team)

2.5 hour Swim Smooth open water clinics - $40 (maximum of 8, if more than 8 additional sessions will be added)

Registration Deadline: Tuesday October 1st, 2019
Entries after the deadline will only be considered subject to space and for an additional late fee of BBD $30

CHEQUES PAYABLE TO “Barbados Federation of Island Triathletes”

Which event do you wish to register for *
Do you wish to register for a swim clinic (limited to first 8 persons)
Sprint relay team name (please enter team members details below before submitting form)
Your answer
FIRST NAME *
Your answer
SURNAME: *
Your answer
DATE OF BIRTH - MM/DD/YY *
MM
/
DD
/
YYYY
MINIMUM AGE TO PARTICIPATE IS 14 YEARS OLD
AGE (on 31st December 2019) *
Your answer
GENDER *
ADDRESS: *
Your answer
COUNTRY: *
Your answer
E-MAIL: *
Your answer
CONTACT #S: [H] [W] [C] *
Your answer
EMERGENCY CONTACT: [NAME & #s] *
Your answer
Are you in interested in obtaining personal accident insurance for $50 per year? If yes we will email you the policy details without obligation to join. *
Do you wish to purchase a dry-fit T-shirt for BBD $40 *
T-SHIRT SIZE: [XS] [S] [M] [L] [XL] [XXL] [XXXL]
Your answer
*
Required
If this is a relay team entry I have entered the details of my fellow teammates below *
Required
SIGNATURE *
Your answer
DATE *
MM
/
DD
/
YYYY
FIRST NAME (relay team member #2)
Your answer
SURNAME (relay team)
Your answer
DATE OF BIRTH (MM/DD/YY)
MM
/
DD
/
YYYY
AGE (on 31st December 2019)
Your answer
GENDER
ADDRESS
Your answer
COUNTRY
Your answer
EMAIL
Your answer
CONTACT #'S
Your answer
EMERGENCY CONTACT & #
Your answer
Do you wish to purchase a dry-fit T-shirt for BBD $40
T-SHIRT SIZE: [XS] [S] [M] [L] [XL] [XXL] [XXXL]
Your answer
SIGNATURE
Your answer
DATE
MM
/
DD
/
YYYY
FIRST NAME (relay team member #3)
Your answer
SURNAME (relay team)
Your answer
DATE OF BIRTH (MM/DD/YY)
Your answer
AGE (on 31st of December, 2019)
Your answer
GENDER
ADDRESS
Your answer
COUNTRY
Your answer
EMAIL
Your answer
CONTACT #'S
Your answer
EMERGENCY CONTACT & #
Your answer
Do you wish to purchase a dry-fit T-shirt for BBD $40
T-SHIRT SIZE: [XS] [S] [M] [L] [XL] [XXL] [XXXL]
Your answer
SIGNATURE
Your answer
DATE
MM
/
DD
/
YYYY
Note: Must be countersigned by a parent or guardian if competitor is under 18 years old.
ENTRIES MUST BE IN BEFORE Tuesday October 1st, 2019
Entry fees (cheques only) are to delivered or posted to:
BFIT, Attn: Anicia Wood
c/o P.O. Box 31,
Barbados Olympic Association
Garfield Sobers Gymnasium & Sports Centre
Wildey, St. Michael, Barbados
9:00am to 4:00pm Monday to Friday

Cheques Payable to "Barbados Federation of Island Triathletes"
Payments of cash (correct change only please) can be made on Fridays at the BOA between 11:00 a.m. and 3:00 p.m.

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service