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First Name *

Last Name *

Gender *

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Date of Birth (YYYY *-MM-DD)

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Hometown *

Team

What is your phone number ? * - International Number

What is your email address ? *

What is your expected swim time (in minutes) ? *

What is your predicted run time (in minutes) ? *

Emergency contact name ? *

Phone number of your emergency contact ? * - International Number

Have you participated to our Aquathlon in the past ? *

Do you understand that this event is organized by Les Amis de Zero Excuse Inc. *

If you are a member of a Triathlon provincial organization (TriNB, TriNS, TriPEI ), please indicate your membership number ?

Do you understand that his event may be independant and not associated with any sport federation ? *

Yes, I understand. Yes, I understand.

Waivers

Waiver - Aquathlon - Zero XZQ

Waiver Aquathlon – Zero XQZ

By indicating your acceptance, you understand, agree, warrant and covenant as follows:

If you are registering a child under the age of 19 or an incapacitated adult you represent and warrant that you are the parent or legal guardian of that party and have the legal authority to enter into this agreement on their behalf and by proceeding with this event registration, you agree that the terms of this Agreement and Waiver shall apply equally to all Registered Parties.

In consideration of your accepting my entry AS A PARTICIPANT, I, intending to be legally bound, do hereby, for myself, my heirs, executors, and administrators, forever waive, release and give up any and all claims, demands, liability, damages, costs and expenses of any kind whatsoever, including personal injuries to me or wrongful death against " Aquathlon – Zero XQZ", Les amis de Zéro Excuse Sports Inc., and Zero Excuses Sports Corporation as well as their director, sponsors, volunteers, contractors, subcontractors and their employees, representatives, agents and heirs, which may arise from my participation in the Aquathlon – Zero XQZ or while traveling to or from the event, even if caused in whole or in part by the negligence or other fault of the parties or person or persons I am hereby releasing, by the dangerous or defective condition of any property or equipment owned, maintained or controlled by them and/or because of their liability without fault.

I FULLY UNDERSTAND I AM FOREVER GIVING UP IN ADVANCE ANY RIGHT TO SUE OR MAKE ANY CLAIM AGAINST THE PARTIES I AM RELEASING IF I SUFFER SUCH INJURIES AND DAMAGES EVEN THOUGH I DO NOT KNOW WHAT OR HOW EXTENSIVE THOSE INJURIES AND DAMAGES MIGHT BE AND AM VOLUNTARILY ASSUMING THE RISK OF SUCH INJURIES AND DAMAGES. I attest that I am physically fit and sufficiently trained for this strenuous competition. I will assume my own medical and emergency expenses in the event of an accident or other incapacity or injury resulting from or occurring in my participation. In consideration of this being an amateur event, I release the rights of any and all photographic material, motion picture, video tape, recordings and/or computer information organizers may wish to release for this event without obligation to me.

I have read and agree to the above *

Digital signature (type your name exactly as entered above "registrants name") *

4th Aquathlon - Zero XQZ

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Division

Waivers

Waiver - Aquathlon - Zero XZQ