Official Entry Form For The CONCHMAN Triathlon

* INCOMPLETE OR UNSIGNED FORMS WILL NOT BE ACCEPTED
 In consideration of the acceptance of my entry in the Grand Bahama Conchman Triathlon, I intend to be legally bound, and do hereby myself, my executors, administrators, heirs, next of kin, successors and assigns, waive and release any and all claims that I may have against Grand Bahama Conchman Triathlon event management, their events committee, officers, directors, members, volunteers, employees, agents or sponsors, including any and all claims for damage caused by the negligence of any of them, arising out of my participation in the events and its related activities, together with any costs including attorney’s fees that may be incurred as a result of any such claim, whether valid or not, and also acknowledge that participation in the Grand Bahama Conchman Triathlon competition carries potential hazard. I have sole responsibility for my personal possessions and athletic equipment during the Grand Bahama Conchman Triathlon and its related activities. I hereby attest and verify that I am physically fit and have sufficiently trained for this competition and consent to receive medical treatment which may be deemed advisable in the event of injury, accident or illness during the Grand Bahama Conchman Triathlon event. I hereby agree with the foregoing and grant full permission to use any photographs, videotapes, motion pictures, recordings or any other record of this event for any purpose. I hereby affirm that I am an amateur athlete as determined by I.O.C.

Please provide the following contact information:

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone
FAX
E-mail

Please identify and describe yourself:

Date of birth
Sex Male Female
T-Shirt Size

Select options that apply:

Relay
Individual

REGISTRATION FEES Individual $40, Residents $25, Team $60, Students (Bahamian residents only): Individual $5, Team $15 . Race fees can be paid at pre-registration meeting on Thursday October 30th or Friday, October 31st from 5-7 PM and pre-race briefing will follow at 7:00PM on Friday at Unexso.
*Fees include: Race Packet (Cap, Race Shirt, Post Race Refreshments and I.D. Number plus 2 drink tickets). No entries accepted on race day.

* Parent or Guardian Signature is required for all applicants under 18

 

For more information:

E-mail: info@conchman.com

* Race Director Bert Bell (242) 373-6226  or 727-5886. P.O. Box F-41517, Freeport, Grand Bahama Island, Bahamas.