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2008 Club Membership Registration 
*First Name:  
*Last Name:  
*Gender:   
*DOB: (mm/dd/yyyy) 
>>>FYI: Your USAT Age Group will be your age as of (12/31/2008
*Address 1:  
Address 2:
*City:  
*State:  
*Postal Code:    
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*Email:    
*Confirm Email:  
*Day Phone: (XXX XXX-XXXX)  
Evening Phone: (XXX XXX-XXXX)
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Member of USAT? | Member #:  
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Seminar Interests (Check all that apply): 








Other Interests or General Comments:
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Wavier and Release
 I acknowledge that the participation in activities related to training for and participation in multisport activities, including but not limited to triathlons/duathlons, and further including but not limited to swimming, bicycling and running ("Activities") has certain inherent physical risks. I understand these risk include, but are not limited to falls, contact with other participants, the effects of the weather, including high heat and/or humidity, the conditions of the road and traffic on the course and injuries sustained while traveling to/from a race or club training. I agree to participate in Activities sponsored by or in any manner associated with the Fort Bend TriPsyclones at my own risk. Furthermore, I certify that I am both medically and physically fit to participate and carry appropriate medical coverage. I agree to not enter or participate in club activities unless I am medically able and properly trained. I realize that Fort Bend TriPsyclones is governed solely by volunteers and was formed to advance the sports of triathlon/duathlon through such Activities, the efforts of which directly affect and benefit me. In consideration of my membership with the Fort Bend TriPsyclones, I, on behalf of myself and my representatives and heirs, assume all risks associated with racing, training, travel, and volunteering to work or participate in club Activities, and knowingly waive, release and forever discharge any person or entity in any manner associated with the Fort Bend TriPsyclones including but not limited to its representatives and successors, officers, directors, members, instructors, speakers, coaches, and sponsors (collectively the "Release Parties") from and all liability, claims, losses, costs or expenses and further waive any such claims against any such Released Parties arising directly or indirectly from, or attributable in any way to any negligent action or failure to act by any Released Parties in connection with sponsorship, organization, or participation in any Activity, including travel to and from such competition or event, in any manner associated with Fort Bend TriPsyclones.

I warrant and represent that I have read the policy preceding this acknowledgement and release, have had ample opportunity to ask and have answered, questions about the foregoing. I execute this release with full knowledge of its significance and without any duress or coercion by anyone associated with the Fort Bend TriPsyclones or any party acting on its behalf.

If I am under 18 acceptance of this waiver should by done only by a legal parent or guardian. Parent or Guardian should put their name in the General Comments field above and specify PARENT or GUARDIAN.

I understand that I will receive a copy of this waiver at the email address above or I can request a printed copy from the club administrator or team captain at anytime.