Do you want to view an existing form?
Arkansas Triathlon Training Camp - Arkadelphia 2021
The form is loading.
Form is loading...
Arkansas Camp -
please provide mobile phone, if available
Emergency Contact Name
Emergency Contact Number
Show Product Options
Would you be interested in purchasing matching shorts?
Please read the waiver carefully: By signing below, you agree, warrant and covenant as follows: Because of the high level of fitness required in this program and the possibility of injury, you must agree to the following Liability Statement before participating in Sport Speed Lab and Triple Threat Tough training programs. 1. In consideration of being allowed to participate in the activities and programs of Sport Speed Lab and Triple Threat Tough, or any of its agents I do hereby waive, release and forever discharge Sport Speed Lab and Triple Threat Tough, or any of its agents from any and all responsibilities or liability from injuries or damages resulting from my participation in any activities conducted by Sport Speed Lab and Triple Threat Tough, or any of its agents. 2. I understand and am aware that swimming, cycling and running are potentially hazardous activities. This is especially true with riding bicycles in traffic, doing open water swims in lakes open to boat traffic, and while running on public streets. I understand that I am solely responsible for my own safety at all times, including use of proper safety practice and equipment. I agree to obey all laws, ordinances, and safety rules. 3. I also understand that fitness activities involve a risk of injury and even death and that I am voluntarily participating in these activities and accept any and all risks of injury, or death. It is understood that there are inherent risks involved in exercising, including but not limited to musculoskeletal injuries, strain on muscles, joints and connective tissues, muscle soreness, muscle cramps, abnormal blood pressure, alterations in menstrual cycle, irregular heartbeat, light headedness, dizziness, nausea and in rare cases, even stroke, heart attack, and death. 4. I do hereby acknowledge that I have been informed of the need for a physician’s approval for my participation in an exercise/fitness program. I also acknowledge that it has been recommended that I have a yearly, or more frequent, physical examination and consultation with my physician as to physical activities, exercise, and use of exercise and training equipment. I acknowledge that I have either had a physical examination and been given my physician’s permission to participate, or that I have decided to participate in activity and use of exercise equipment and machinery without the approval of my physician. 5. Consent and information Release (“Consent”): I hereby grant permission to Sport Speed Lab and Triple Threat Tough, or any of its agents, to render preventative or first-aid assistance or seek treatment or medical care that seems reasonably necessary, including hospitalization, for my health and well being. I also give permission to Sport Speed Lab and Triple Threat Tough, or any of its agents, to use and disclose my personal health information (“PHI”) in the ways described in this form. I allow Sport Speed Lab and Triple Threat Tough, or any of its agents, to use my PHI as necessary for purposes related to my treatment. I allow my PHI to be given to doctors, hospitals, ambulance companies, coaches, family members, and others involved in my care and treatment. My PHI may also be used and given out as necessary to run the training program. This Release and Consent will be governed by and subject to the laws (except the couice of law principles) and exclusive jurisdiction of the courts of the State of Texas. 6. Personal Release - I give permission to Sport Speed Lab and Triple Threat Tough, or any of its agents, to free use of my name, picture, and voice in any broadcast, telecast, print account, or any other account in any medium of this training and race. (Ex: Pictures and video). I do hereby assume all responsibility for my participation with Sport Speed Lab and Triple Threat Tough, or any of its agents and activities. I do hereby assume all responsibility for my participation with Sport Speed Lab and Triple Threat Tough, or any of its agents and activities.
Read through the agreement
I have read and agreed to the waiver
Is the participant 18 or older?
18 or older
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian. If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Discount, Tracking, or Charity Code
The payment and credit card section is not visible because there is nothing owed or form fields have not been fully completed.
Credit Card #
Your payment is encrypted and 100% secure.
click the "pay now" button to submit your order then send a check (or pay in person) at the address above.
1. Venmo the total amount to the Phone #:
2. Make sure you enter the code,
in "What's it for".
3. Click the "pay now" button.
Enter a Check Number
Enter a Check Amount
Do you want to send email receipt to the participant
I agree to the RaceReach
Terms of Service
Stand alone https page