Henley-on-Thames Triathlon
22nd June 2014
Please fill in all sections applicable (captains name only for relay race team)
Please print & post this form
First Name
Last Name
Address
Town
Tel Day
County
Tel Eve
Post code
Nationality
Email  
D.O.B
Sex
 Male Female
   
Age on 31 Dec 2014
Will 2014 be your first year competing at triathlon ?
Yes No
 
Will you be a BTF member on race day ?
Yes No
 
Team or club name (if any)
How did you get to know about this triathlon event ?
Competed previously
220 Magazine
Poster
UK Triathlon leaflet
Told by a friend
Internet
   
Other (Please specify
ESTIMATED TIME swim 200m mins secs Fun
ESTIMATED TIME swim 400m mins secs Sprint
Please tick if you do not wish to receive information regarding our future events
 
RACE SELECTION (Tick the box of the race/s you wish to enter)
     
Fun Triathlon (200m Swim - 12.5k Bike - 2.5k Run)
£50.00
Super Sprint Triathlon (200m Swim - 12.5k Bike - 2.5k Run) £45.00 BTF Member
Super Sprint Triathlon (200m Swim - 12.5k Bike - 2.5k Run)
£50.00 Non BTF Member
Sprint Triathlon (400m Swim - 25k Bike - 5k Run) £45.00 BTF Member
Sprint Triathlon (400m Swim - 25k Bike - 5k Run) £50.00 Non BTF Member
Relay Triathlon (400m Swim - 25k Bike - 5k Run) (One competitor for each leg!)    £55.00
 
BTF Members will be asked to produce their race licence at registration
Sorry no entries on race day. No need to send S.A.E.
     
EVENT SHIRT SELECTION (Tick the box of the shirt/s you wish to order and select a size)
     
Henley-on-Thames Triathlon 2014 Race T-shirt
S
M
L
XL
£9.95  
Henley-on-Thames Triathlon 2014 Race Polo Shirt
S
M
L
XL
£14.95  
Henley-on-Thames Triathlon 2014 Race Technical T-shirt
S
M
L
XL
£19.95  
     
Please consult your bank statement for confirmation of entry.
Final details will be sent to you roughly 7 days before the event.
PAYMENT TOTAL ENCLOSED
£
 
Please make cheque/postal order payable to  
“UK Triathlon” & post to:
Unit 20, Cockshades Farm, Stock Lane, Wybunbury, Cheshire, CW5 7HA
 
Would you like to compete for a charity Yes No
 
DISCLAIMER Min age 16 on the 31 Dec 2014.
Unsigned entry forms cannot be accepted & will be returned. I declare that I am of good health & fit to compete in a triathlon & do so at my own risk. I will abide by the rules of the organisers and agree to their terms & conditions. I will cycle with care & attention & abide by the normal rules of the road. I accept that the organisers & their friends & associates are not liable for any loss, damage, claim, injury (including fatal) or expense that may arise in consequence of my participation in any of the above events.
       
Sign Print Date