Team Contact:
First
Name |
 |
| Last Name |
|
| Address 1 |
|
| Address 2 |
|
| Address 3 |
|
| Town |
|
| County |
|
| Postcode |
|
| Phone No. |
|
| Mobile Phone |
|
| Email Address |
|
| Team Name |
|
First Member
DOB
Participants must be 15 or over (team swimmers 12 or over)
on 31/12/08 |
|
| Second Member DOB |
|
| Third Member DOB |
|
| Predicted Swim Time |
|
| Predicted Bike Time |
|
| Predicted Run Time |
|
| Does any team member have any medical
conditions? |
|
Interesting information: e.g.: charity,
first timer, target, other reason.
Note: This may be used
during our race commentary and/or press releases |
|
Submitting this form implies acceptance of the
following disclaimer:
I/my team enter entirely at my/our
own risk and agree that the organisers will in no way be held responsible
for any injury, illness or loss incurred to person or property as a result
of this event. |
|
|
- Required field
|