DUATHLON CHAMPS ENTRY

Thank you for your entry - Please read and complete ALL sections of this form - after the Indemnity section state "I Agree" and then click SEND. You will receive a confirmation email with your Race Number and additional instructions for your race.

RACE ENTRY FEES - US$ 10 per individual

USD Cash payments accepted on the day / Prepayments in ZWL by Bank transfer to CABS PLATINUM - Acc Name: TRIATHLON ZIMBABWE - Acc # 1003103898 - Contact TREASURER 0772 270330 for rate applicable. Proof of payment to be sent by email to tim@cropserve.co.zw. ECOCASH to 0788 804508 (recipient Kelly Bauer-Bennett)

NAME OF PARTICIPANT (required)

DATE OF BIRTH (required)

GENDER (required)

ARE YOU VACCINATED - answer YES / NO (required)

Race Entering - PLEASE SPECIFY IN BOX BELOW (required)

AG SPRINT CHAMPIONSHIP

JUNIOR SPRINT CHAMPIONSHIP

YOUTH SUPERSPRINT CHAMPIONSHIP

Your Contact email address (required)

Your Contact mobile number (required)

Race Entry Fee Method of Payment - CASH on the day / PREPAID transfer CABS / PREPAID ECOCASH - PLEASE SPECIFY (required)

INDEMNITY -

By completing this Online Registration Form, I agree to abide by the protocols and procedures put in place by the organisers of the event. I understand that I will take part in this event at my own risk and will not hold Triathlon Zimbabwe, it’s sponsors, organisers, officials, coaches, employees or assistants, responsible for any accident, illness, injury, or loss of, or damage to property, which may occur as a result of my participation in this event. I hereby indemnify against all claims arising out of said participation in this event

PLEASE STATE "I AGREE" IN BOX BELOW