Team Mate Information | |
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| Name | |
| Street Address | |
| City ST ZIP Code | |
| Home Phone | |
| Work Phone | |
| E-Mail Address | |
| Age/Date of Birth | |
| Gender | |
| Type of Membership (based on ages as recognized by USAT) | Adult (19 and up) Older Youth (15-19) Youth (under 14) |
| USAT Membership # | |
Agreement and Signature | |
| Agreement and Waiver: As a Team Mate, I agree to actively fund raise for the Mac Crutchfield Foundation and to participate/compete in at least one event every six months in order to remain in good standing as a Team Mate of Team TRIMac. I recognize that competing in triathlons (swimming, biking, running) and volunteering at athletic events are potentially hazardous activities. I acknowledge that I should not enter a race or event unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to complete the event. I assume all risks associated with competing and volunteering at such events including but not limited to: falls, contact with other participants, the effects of the weather – including high head and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application for membership, I, for myself and anyone entitled to act on my behalf, waive and release Team TRIMac, Team IRONMac, the Mac Crutchfield Foundation, all sponsors, their representatives and successors from all claims of liabilities or any kind arising out of my participation in these events even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I understand that this waiver is in effect indefinitely until my membership is terminated. | |
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| Name (printed) | |
| Signature: Parent or Guardian must sign for members under 18 | |
| Date | |
Fee(s) Included: $ | |
Please tell us about your personal interest or tie to Team TRIMac (not required) | |
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| Membership Fee One Time | | Schwag: Jersey and shorts by Louis Garneau | |
| Adult | $150.00 | | Custom Jersey |
| | $250.00 | | Competition Kit: Custom Jersey and Tri Shorts |
| Youth/Child | $150.00 | | Competition Kit: Custom Jersey and Tri Shorts |
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| | | Note: | Fee(s) to be included with application for membership along with desired size(s) for jersey and shorts. |
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| Suggested Fund Raising Goal(s) | | Schwag/Incentive | |
| Adult | | | |
| Team TRIMac | $250.00 per event | | Headsweats Visor & Yankz! multi sport laces |
| Team TRIMac | $500.00 per event | | Event entry fee (up to $150) & Headsweats Visor & Yankz! multi sport laces |
| Team TRIMac | $1000.00 per event | | Event entry fee (up to 1/2 of Ironman fee) & Headsweats Visor & Yankz! multi sport laces; 2 tickets to annual dinner with Ryan Lochte |
| Team IRONMac | $1500.00 per event | | Event entry fee (Ironman fee) & Headsweats Visor & Yankz! multi sport laces; 2 tickets to annual dinner with Ryan Lochte |
| Team IRONMac | $2500. per event | | Event entry fee (Ironman fee) & Headsweats Visor & Yankz! multi sport laces; 2 tickets to annual dinner with Ryan Lochte; name of choice on sponsor banner at finish line |
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| Youth/Child | | | |
| Team TRIMac | $100.00 per year | | Headsweats Visor & Yankz! multi sport laces |
| Team TRIMac | $250.00 per year | | Event entry fee (up to $150) & Headsweats Visor & Yankz! multi sport laces |
| Team TRIMac | $500.00 per year | | Event entry fee (up to $150) & Headsweats Visor & Yankz! multi sport laces; tickets for family to annual dinner with Ryan Locthe |
| Team TRIMac | $1000.00 per year | | Event entry fee (up to $150) & Headsweats Visor & Yankz! multi sport laces; transition bag, tickets for family to annual dinner with Ryan Locthe |
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| | | *NOTE: | Event entry fees will be provided on a reimbursement basis. |
