BOOKING PAGE

Team Triathlon – Autumn Event

Booking Form – 1st September 2024

Event disclaimer:

We accept that taking part in this event is by its nature hazardous and contains inherent risks we agree that we participate entirely at my own risk and accept that the event organiser and associates are not liable for any loss, damage, claim, expenses, injury or accident which may arise as a consequence of this event. We will swim / bike / run with care and attention, abiding by the rules of British Triathlon Federation1. We remain responsible for my own property and actions. We are in good health and have done sufficient training to safely complete the course.

(1) www.britishtriathlon.org

We have read and understand the event disclaimer and my entry into the event is proof.

All our transactions are done off site using Stripe Payment Gateway. This is a very reliable way of taking payment and was used with great success last year.

Entry the Triathlon Team for £61.50

Team Triathlon Form – 1st September 2024

(closing date the week prior)

Please fill in your details carefully.

Once you have filled in the form and clicked “submit” – you should get a short thank you note and an email will be sent confirming your entry. Should the internet fail mid or after finishing completing of the form – check your email for confirmation before attempting to re-enter your details in case you end up entering twice.

Call 07887788948 for any last minute entry enquiries.

Autumn Triathlon 1st September 2024 - Team entry form

Adults form for a Team entry for the Triathlon on the 1st September 2024

Read the disclaimer?*
- I have read and understand the disclaimer
Name - Lead*
Full Name
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Phone*
Email*
Gender*
- Male
- Female
Date of Birth*
DD slash MM slash YYYY
Club / Organisation*
put 'none' if you are not affiliated
1st Name - 400m Swim*
Full Name
Please estimate your swim time for 400m*
for example .... 7:45 and include the :
2nd Name - 20k Ride*
Full Name
3rd Name - 5k Run*
Full Name
Emergency Contact Name and No.*
Name Number
Triathlon Team Entry*
Triathlon Team is £61.50
This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes.
Credit Card*
The receipt for payment will say "Southam Lions Club Charitable Trust Fund"

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name