or, Qualified for SOS at/time:

(please include documentation)

PLEASE READ CAREFULLY BEFORE SIGNING ACKNOLEDGMENT, WAIVER AND RELEASE FROM LIABILITY (AWRL)

I acknowledge that a triathlon or bi-sport/duathlon event is an extreme test of a person's physical and mental limits and carries with it the potential for death, serious injury and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATION IN TRIATHLONS OR BI-SPORT/DUATHLON EVENTS. I certify that I am physically fit, have sufficiently trained for participation in this event and have not been advised against participation by a qualified health professional. I acknowledge that my statements on this AWRL are being accepted by US Triathlon (UST) in consideration for allowing me to become a member in UST and are being relied upon by UST and the various race sponsorts, organizers and administrators in permitting me to participate in any UST sanctioned event.

In consideration for allowing me to become a member in UST and allowing me to participate in UST sanctioned events, I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I expressly acknowledge that it is my intent to take these actions: (a) I AGREE to abide by the Competitive Rules adopted by UST, including Medical Control Rules as they may be amended from time to time, and I acknowledge that my membership may be revoked or suspended for violation of the Competitive Rules; (b) I AGREE that prior to participating in an event, I will inspect the race course, facilities, equipment, and areas to be used and if I believe that they are unsafe I will immediatelly advise the person supervising the event, activity facility, or area; (c) I WAIVE, RELEASE AND DISCHARGE from any and all claims, losses, or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, theft, or damage of any kind, including economic losses, which may in the future arise out or relate to my participation in or my traveling to and from a UST sanctioned event. THE FOLLOWING PERSONS OR ENTITIES: UST, EVENT SPONSORTS, RACE DIRECTORS, EVENT PRODUCERS, VOLUNTEERS, ALL STATES, CITIES, NEW YOR TRIATHLETE ASSOCIATION, MOHONK MOUNTAIN HOUSE, MOHONK PRESERVE, SHERIFF'S DEPARTMENT, ULSTER COUNTY, PALISADES INTERSTATED PARK COMMISSION, THE TOWNS OF NEW PALTZ, ROSENDALE, STONE RIDGE, HIGH FALLS, ROCHESTER, ULSTER COUNTY OR LOCALITIES IN WHICH EVENTS OR SEGMENTS OF EVENTS ARE HELD AND THE OFFICERS, DIRECTORS, EMPLOYEES, REPRESENTATIVES, AND AGENTS OF ANY OF THE ABOVE, EVEN IF SUCH CLAIMS, LOSSES OR LIABILITIES ARE CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OF PERSONS I AM HEREBY RELEASING OR ARE CAUSED BY THE NEGLIGENT ACTOS OF OMISSIONS OF ANY OTHER PERSON OR ENTITY; (d) I ACKNOWLEDGE that there may be traffic or persons on the course route, and I ASSUME THE RISK OF RUNNING, BIKING, SWIMMING, OR PARTICIPATING IN ANY OTHER EVENT SANCTIONED BY UST. I also ASSUME ANY AND ALL OTHER RISKS associated with participating in UST sanctioned events including but not limited to falls, contact and/or crashes with other participants, effects of weather including heat and/or humidity, defective equipment, the condition of the roads, water hazards, contact with other swimmers or boats, and any hazard that may be posed by spectators or volunteers, all such risks being known and appreciated by me, I further acknowledge that these risks include risks that may be the result of negligence of the persons or entities mentioned above in paragraph (c) or of other persons or entities; (e) I AGREE NOT TO SUE any of the persons or entities mentioned in paragraph (c) or any of the claims, losses or liabililities that I have waived, released, or discharged herein; (f) I INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned above in paragraph (c) from any and all claims made or liabilities assessed against them as a result of (i) my actions or inactions, (ii) the actions, inactions, or negligence of others including parties hereby indemnified, (iii) the conditions of the facilities, equipment, or areas where the event or activity is being conducted, (iv) the Competitive Rules, or (v) any other harm caused by and occurrence related to a UST sanctioned event, and (g) I GRANT PERMISSION for the use of my name and/or likeness relating to my participation in a UST sanctioned event and I WAIVE all rights to any future compensation to which I may otherwise be entitled as a result of the use of my name or likeness.

I HEREBY AFFIRM THAT I AM 18 YEARS OF AGE OR OLDER, I HAVE READ THIS DOCUMENT, AND I UNDERSTAND ITS CONTENTS

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