Please fill in the requested information below press the preview button, verify information
on the next screen then press the "Pay Here" button where you will be taken to the Paypal
processing site where you MUST select payment method and provide any information they
require. Once successfully paid you will be redirected to theSPG Triathlon thank you page.
You will receive payment confirmation email both from Paypal and Entry confirmation from
us. |
Visa, M/C, Paypal ** ALL Payments are handled securely by Paypal ** DATA GRAPHX
and will appear on your Credit Card OR /Paypal statement as such.
SORRY ALL ENTRY FEES ARE NON-REFUNDABLE |
| Fees: |
EARLY: Before April 12th 2010
$68.00
(includes $3.00 processing fee)
ALL Entries Receive a Cool Triathlon Back Pack
LATE: After April 12th 2010
$78.00 (
includes $3.00 processing fee) |
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(E-mail)
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xxx-xxx-xxxxx |
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xxx-xxx-xxxxx |
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mm/dd/yyyy format |
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As of May 9/2010 |
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SORRY Olympic & Sprint are FULL |
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mm:ss format |
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Includes $3 processing fee. |
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| Please Help our Announcer and Tell us about Youself |
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How many Tris have you done? |
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How many SPlash, Pedal Gasp Tris? |
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| Please Read and Agree to the Waiver |
I hereby agree to comply with all the rules and regulations and event instructions of the Runners Soul
Triathlon and its directors. I hereby consent to receive medical treatment deemed advisable in the event
of injury, accident and illness during the Runners Soul Triathlon event. I hereby agree that my entry fee
will be non-refundable. In consideration of your acceptance of this race entry, I, for myself, my heirs,
executors, administrators and assigns, forever waive, release and discharge any and all rights,
demands, claims for damages and causes of suit or action known or unknown, that I may have against
Runner's Soul and any and all participation race sponsors and supporters and directors, officers,
employees and agents of such parties, for any and all injuries in any manner arising or resulting from
my participating in said race. I attest and verify that I have full knowledge of the risks involved in this
race, that I assume those risks, that I will assume and pay my own medical and emergency expenses in
the event of accident, illness or other capacity, regardless of whether I have authorized such
expenses and that I am physically fit and sufficiently trained to participate in this race. |
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