PEOPLES BANK OF ALABAMA SPRINT TRIATHLON
200 YD SWIM 8 MILE BIKE 2 MILE RUN

Cullman Wellness and Aquatic Center

Friday, September 19, 2014 Packet Pick Up from 10am-4:30pm The Link of Cullman County

Saturday, September 20, 2014 at 5:30am-7:00am Packet Pick Up

7:30am RACE BEGINS   10:30AM AWARDS

Register at Active.com/ The Link of Cullman County

ENTRY FEE: $40 Individual *$50 after August 20, 2014  $70 Team Relay  *$80 after August 20, 2014
                      $20 Child (7-15yrs old) *$30 after August 20, 2014

PLEASE PRINT CLEARLY

Name                                                                                                                                                                                                                                    

Address                                                                                                                                                                                                                 
City                                                         State                                      Zip                          Phone                                                                                  

Email                                                                                                      Age at race day______________ D.O.B.                                          

Male            Female               Swim Time                          (If you do not specify a swim time, you will be placed at the back of the line)

? I would like to make a donation to The Link of Cullman County, Inc. in the amount of $                                              

? T-shirt Size (Please Circle One)  S               M            L              XL           2XL         ?Individual           ?Clydesdale        ?Athena

?Beginner            ?Kids 10 and under            Make checks payable to: The Link of Cullman County 1101 3^rd Ave SE Cullman, AL 35055

I hereby affirm my desire to participate in the Triathlon on Saturday, September 20, 2014 at 7:00 am sponsored by Peoples Bank of Alabama and The Link of Cullman County, Inc. Realizing that there is risk in this activity and in consideration of my being allowed to participate in this activity, I personally assume all risks in connection with the triathlon. I further agree to release and hold harmless THE FOLLOWING ENTITIES OR PERSONS: The Link of Cullman County, Inc, City of Cullman or any employee of Cullman, Cullman Wellness and Aquatic Center, any sponsors, and the directors, officers, employees, volunteers, representatives, and agents of the above parties, the event holds, event sponsors, event volunteers, any and all claims and liabilities of any type whatsoever and for damages to, loss or destruction of any property or injury, sickness, or death which my now or hereinafter arise out of, result from, or in any way be connected with my participation in the above mentioned Peoples Bank of Alabama Sprint Triathlon. I understand that The Link of Cullman County, Inc. nor any of its agencies, provides health insurance, nor it is my responsibility to obtain such insurance. I further state that I am lawful age and legally competent to sign this release; that I understand the terms herein are contractual and not a mere recital; and that I have signed this document as my own free act. I understand that a medical examination to assure myself of physical fitness is desirable, that obtaining such an examination is my own responsibility, and assume my own responsibility of physical fitness and capacity to participate in such event, and I am physically fit. I hereby agree to comply with all rules and regulations and event instructions of The Link of Cullman County, Inc., Peoples Bank of Alabama Sprint Triathlon. I also give permission for the free use of my name and picture in any media account of promotion of this event. Finally, I agree that in the event of race disqualification, or my failure to attend, my entry fee shall not be refunded.

I hereby certify that I have read this document; and I understand its content.

Signature                                                                                                                                                              Date                                                      
(Signature of Parent/Guardian if entrant is under 18)