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http://www.triathlonireland.com http://www.midlandtri.com |
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TI Ref No: |
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Email: |
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Phone No.: |
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Category of Membership. Tick box |
Midland Tri Club Membership |
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20.00 |
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Full TI Membership |
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50.00 |
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Full Student TI Membership |
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30.00 |
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Youth/Jnr TI Membership |
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5.00 |
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Associate TI Membership* |
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5.00 |
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Total Due |
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I wish my TI
membership to be dealt with by the membership Secretary Y/N |
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Date of Birth
(dd/mm/yyyy) ___ /____ / 19____ Age |
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Date: |
Signature |
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Administration Check List |
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Signed Midland
Tri Club Application Form returned with fee y/n |
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Signed TI
Application form returned with fee y/n/na |
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TI ref No.
provided by self applicator to TI y/n |
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Post to: Deirdre
Roche, No. 5 Green Park, Mullingar, Co. Westmeath: (087) 6404445 
*Associate
membership provides insurance cover for stewarding, social events and
administrative work.
I acknowledge that a triathlon or Duathlon event is an extreme test of a persons physical and mental limits and carries with it potential for death, serious injury, and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN TRIATHLONS OR BI SPORT/DUATHLON EVENTS. I certify that I am physically fit and have sufficiently trained for participation in this events(s), and have not been advised against participation by a qualified health professional. Acknowledge that my statements on this AWRL are been accepted by Triathlon Ireland(TI) in consideration for allowing me to become a member in TI and are been relied on by TI and various race sponsors, organizers and administrators in permitting me to participate in any TI sanctioned evens, I hereby take the following action for myself, my executors, administers, 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 to abide by the Competitive Rules adopted by TI, including the Medical Control Rules as they may be amended from time to time, and I acknowledge that my membership may be revoked or suspended for violation of the Competitive Rules.
(b) I AGREE that prior to participating in an event I will inspect the race 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 ore area.
(c) 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 related to my participation in or my travelling to and from a TI sanctioned event, THE FOLLOWING PERSONS OR ENTITIES: TI, EVENT SPONSORS, RACE DIRECTORS, EVENT PRODUCERS, VOLUNTEERS, ALL CITIES COUNTRIES, OR LOCALITIES IN WHICH EVENTS OR SEGMENTS OF EVENTS ARE HELD, AND THE OFFICERS, DIRECTORS, EMPLOYERS, REPRESENTITIVES AND AGENTS OF ANY OF THE ABOVE. EVEN IF SUCH CLAIMS, LOSSES, OR LIABILITIES ARE CAUSED BY NEGLIGENT ACTS OR OMISSIONS OF THE PERSONS I AM HEREBY RELEASING OR ARE CAUSED BY NEGLIGENT ACTS OR OMISSIONS OF ANY OTHER PERSON OR ENTITY:
(d) I ACKNOWLEDGE , that there may be traffic or persons ON THE course, route and I ASSUME THE RISK OF RUNNING, BILING, SWIMMING OR PARTICIPATING IN ANY OTHER EVENT SANCTIONED BY IT. I also ASSUME ANY AND ALL OTHER RISKS associated with participating in TI sanctioned events including, but not limited to falls, contact and/or effects with other participants, effects of weather including heat and humidity, defective equipment, the condition of the roads, water hazards, contact w3ith 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 (c) or of other persons or entities.
(e) I AGREE NOT TO SUE any of the persons or entities mentioned above in paragraph (c) for any of the claims, losses, or liabilities that I have waived, released, or discharged herein.
(f) I IDENTIFY AND HOLD HARMLESS the persons or entities mentioned above in paragraph (c) of any and all claims made or liabilities assessed against them as a result of: (i) my actions or inactions: (ii) the actions, inactions or negligence of others including those parties hereby indemnified: (iii) the conditions of the facilities, equipment, or areas where the event or activity is being conducted: (iv) the competitive rules; or (v) any other harm caused by occurrence related to TI sanctioned event.
(g) I GRANT PERMISSION for the use of my name and / or likeness related to my participation in a TI sanctioned event, and I WAIVE all rights to any future compensation to which I may otherwise be entitled as a result of the use of my name or likeness
(h) I AGREE to my membership details/record been held on computer database and shared with other agencies involved in regulating sport as necessary; and (i) I UNDERSTAND that Triathlon Ireland may inform me of business by post, email or by posting relevant information on its website (www.triathlonireland.com)
I HEREBY AFFIRM THAT I AM EIGHTEEN (18) YEARS OLD OR
OLDER, I HAVE READ T5HIS DOCUMENT, AND I UNDERSTAND ITS CONTENTS
© Triathlon Ireland Signed:
_____________________________________________
Please tick
Date: __________/___________/__________________-
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Yes,
I have fully read and accepted the AWRL
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No, I do not accept the AWRL |
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*Associate
membership provides insurance cover for stewarding, social events and
administrative work.