Pegasus Elite Triathlon Team 2010-2011 Season

Application and Waiver

(print and mail)

Date: ____________________

Last Name___________________________ First Name_________________ MI_____

Street Address_________________________________________________________

City___________________________________________ State_____ Zip___________

Birth Date_____________ Home Phone (______) ________________

Work Phone (_______) ____________________

E-mail Address ___________________________

USAT Member # _____________________ Expires: ______________

EMERGENCY INFORMATION:

In case of emergency, please notify:

Name _______________________________________________________________

Address______________________________________________________________

Telephone __________________________

Privacy Notice

 Team Pegasus provides a list of club members’ names addresses and email to USA Triathlon so that members will be eligible for the annual membership discount.

___ I do not want my information released to USAT

___ I do not want my name, town and email listed on the team website

___ I do not want my information released to official team sponsors

 Annual Dues: $75.00  includes a $25 credit towards a uniform and $50 credit towards coaching.

Paid (   ) Date: _________________

Make checks payable to: Pegasus Elite Athlete Management

Mail to:  Beth Kenney, P.O. Box 966, Duxbury, MA  02331

Waiver

(Signature and date required)

Please read carefully before signing acknowledgment, waiver and release from liability (AWRL).

I acknowledge that a triathlon/multi-sport event is an extreme test of a person’s physical and mental limits and carries with it potential for death, serious injury and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN TRIATHLON/MULTI-SPORT TRAINING AND COMPETITION. I certify that I am physically fit and have sufficiently trained for participation in triathlon/multi-sport events, and have not been advised against participation by a qualified health professional. I acknowledge that my statements on this AWRL are being accepted by TEAM-PEGASUS in consideration for allowing me to become a member of TEAM-PEGASUS and are being relied upon by TEAM-PEGASUS and its SPONSORS in permitting me to participate in any TEAM-PEGASUS event.

In consideration for allowing me to become a member of TEAM-PEGASUS and allowing me to participate in TEAM-PEGASUS events, I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I expressly acknowledge that it is my intent to take these actions: (a) I AGREE that prior to participating in an event I will inspect the course, facilities, equipment, and areas to be used and if I believe any are unsafe I will immediately advise the person supervising the event activity facilities or area; (b) I waive, release and discharge from any and all claims, losses or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, theft or damage of any kind, including economic losses, which may in the future arise out of or be related to my participation in or my traveling to and from an TEAM-PEGASUS event, THE FOLLOWING PERSONS OR PERSONS ASSOCIATED WITH: TEAM-PEGASUS, TEAM-PEGASUS BOARD OF DIRECTORS, SPONSORS, RACE DIRECTORS, EVENT PRODUCERS AND VOLUNTEERS EVEN IF SUCH CLAIMS, LOSSES, OR LIABILITIES ARE CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OF THE PERSONS I AM HEREBY RELEASING OR ARE CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OF ANY OTHER PERSON OR ENTITY; (c) I ACKNOWLEDGE, that there may be traffic or persons ON THE course, route and I ASSUME THE RISK OF RUNNING, BIKING, SWIMMING OR PARTICIPATING IN ANY OTHER TEAM-PEGASUS EVENT. I also ASSUME ANY AND ALL OTHER RISKS associated with participating in TEAM-PEGASUS sanctioned events including, but not limited to, falls, contact and/or effects with other participants, effects of weather including heat and/or humidity, defective equipment, the condition of the roads, water hazards, contact with other swimmers or boats and any hazard that may be posed by spectators or volunteers. All such risks being known and appreciated by me, I further acknowledge that these risks include risks that may be the result of the negligence of the persons or entities mentioned above in paragraph (b) or of other persons or entities; (d) I AGREE NOT TO SUE any of the persons or entities mentioned above in paragraph (b) for any of the claims, losses, or liabilities that I have waived, released, or discharged herein; (e) I INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned above in paragraph (b) from any and all claims made or liabilities assessed against them as a result of the claims, losses or liabilities that I have waived, released or discharged herein.

I HEREBY AFFIRM THAT I AM EIGHTEEN (18) YEARS OLD OR OLDER, I HAVE READ THIS DOCUMENT, AND I UNDERSTAND ITS CONTENTS.

_______________________________     

PRINT NAME                              

_______________________________

SIGNATURE                       

_______________________________

DATE  

TEAM-PEGASUS TENT SERIES

The Tent Series focuses on key team races. Some are Official TEAM-PEGASUS Volunteer Events while others are major races where TEAM-PEGASUS can really show our support.  The Tent Series will consist of 10 races. Team-Pegasus members are encouraged to race, relay, and volunteer at as many races as possible. Points will be given for participation in a variety of ways. Look for the red, white & blue TEAM-PEGASUS Tent at all of these events!

2010 EVENT SCHEDULE (dates subject to change)

RACE REWARDS PROGRAM

In an effort to reward TEAM-PEGASUS members for racing, we have established the Race Rewards Program. The program is set up for the Podium Finisher or the complete newcomer. TEAM-PEGASUS members will be eligible to win gift certificates and other prizes at the end of the season. Names will be drawn at the Year End Banquet. The more entries you have, the greater your chances of winning.

Limit one prize per person.

PRIZES

5 people will receive merchandise or sponsor gift certificates and/or free race entries at the Year-End Banquet!
For more information, contact Beth Kenney @ bak5557@aol.com.

MEMBERSHIP BENEFITS

• Periodic emails with training and nutrition tips

• Inclusion in the annual Team Pegasus Century+

• Networking with other experienced triathletes

• Information on group workouts

• Participation in the race rewards program

• Discounts at Cycle Lodge