PORT ST. CHARLES TRIATHLON JULY 7th 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.
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PORT ST. CHARLES SPRINT TRIATHLON 2019
EVENT DATE: 7th July, 2019, 6:30 a.m. Location: Port St. Charles
Entries to be submitted by July 5 at 11:59 pm
Entries after the deadline can be accommodated subject to space for an entry fee of $150.
Relay consists of 3 person teams where each person completes one leg of a sprint triathlon in succession.

Which event do you wish to register for *
Do you plan attend the delicious buffet breakfast put on by Port St. Charles after the event? The buffet will include sausage scrambled eggs, baked beans, bacon, pancakes, muffins, toast and coffee or tea all for $50 and kids under 12 for $35 (plus 10% service charge). *
Sprint relay team name and team members, birthdate (mm/dd/yy) and gender (3 members per team) *all team members information is to be entered below
Your answer
RELAY MINIMUM AGE TO PARTICIPATE IS 12 YEARS OLD.
FIRST NAME *
Your answer
SURNAME: *
Your answer
DATE OF BIRTH - MM/DD/YY *
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AGE (on 31st December 2019) *
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GENDER *
ADDRESS: *
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COUNTRY: *
Your answer
E-MAIL: *
Your answer
CONTACT #S: [H] [W] [C] *
Your answer
EMERGENCY CONTACT: [NAME & #s] *
Your answer
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Required
Signature: *
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Date: *
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FIRST NAME
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SURNAME
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DATE OF BIRTH - MM/DD/YY
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Age (as at 31st December 2018)
Your answer
Gender
Address
Your answer
Country
Your answer
Email address
Your answer
CONTACT #S: [H] [W] [C]
Your answer
EMERGENCY CONTACT [NAME & #S]
Your answer
SIGNATURE
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DATE:
MM
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FIRST NAME
Your answer
SURNAME
Your answer
DATE OF BIRTH (MM/DD/YY)
Your answer
AGE (as at December 31st 2018)
Your answer
Gender
ADDRESS
Your answer
COUNTRY
Your answer
EMAIL ADDRESS:
Your answer
CONTACT #S: [H] [W] [C]
Your answer
EMERGENCY CONTACT [NAME & #S]
Your answer
SIGNATURE
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DATE:
MM
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Note: Must be countersigned by a parent or guardian if competitor is under 18 years old.
ENTRIES MUST BE IN BEFORE 11:59 p.m. on Friday July 5th, 2019
Entry fees (cheques only) are to be delivered in sealed envelopes addressed to:
BFIT, 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"

N.B. Payments by cash must be arranged by contacting BFIT

Questions: email triathlonbarbados@gmail.com

I have read and understand the payment options above. *
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