Haleiwa Triathlon

North Shore's iconic Triathlon is happening on June 17, 2023 (SAT).

RACE DATE: Saturday, June 17, 2023
WHERE: Pua'ena Point Beach Park @ 5:45am
SPRINT COURSE (USAT age 15 and over): 400 meter swim, 12 mile bike & 3 mile run!
Youth Course (USAT age 7 to 14): 150 meter swim, 4 mile bike & 1.5 mile run!

Late Entries after 6/1/2023 are not guaranteed a t-shirt or a medal!
No Youth Tshirt sizes available (only UNI-SEX adult sizes)

Awards: Overall Top 3 female & men. Top 3 female & men in 5 year age groups (except for youth). Beach Cruiser: 1st female & male only.
Teams: Top 3 male, female & mixed.

Packet Pick Up: Please refer to our website for more information www.haleiwatriathlon.com

Entry Fees	Before Jan 01, 2023	Before May 30, 2023	Before Jun 15, 2023
Sprint Triathlon Individual	$125.00	$150.00	$165.00
Sprint Triathlon Relay Team	$145.00	$170.00	$180.00
Youth Triathlon (USAT age 7-14)	$45.00	$50.00	$55.00

Refund & Rollover Policy:
We do not offer any refunds; however, if you cannot make it you have time to contact us until April 30th to rollover your entry to the next year.
We do not accept any rollover requests AFTER April.30th.

I agree to the USAT waiver (online or at packet pick up). I release the North Shore Triathlon staff, volunteers and sponsors from claims or liabilities arising out of my participation in this event, including pre-and-post activities. I give permission for the free use of my name, voice and photo in any broadcast, telecast, advertisement or promotion of the event.

WARNING: READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF LEGAL RIGHTS AND DEPRIVES YOU
OF THE RIGHT TO SUE USA TRIATHLON AND OTHER PARTIES. DO NOT SIGN THIS AGREEMENT UNLESS YOU HAVE READ IT IN ITS ENTIRETY.
SEEK THE ADVICE OF LEGAL COUNSEL IF YOU ARE UNSURE OF ITS EFFECT.
IN CONSIDERATION of USA Triathlon (“USAT”) allowing me to participate in any USAT sanctioned event (the “Event” or “Events”) as either a member of USAT or through the issuance of a single event license or permit; I, for myself, and on behalf of my spouse, children, parents, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”);
1. I hereby represent that (i) I am in good health and in proper physical condition to participate in the Event; and (ii) I am not under the influence of alcohol or any illicit or prescription drugs which would in any way impair my ability to safely participate in the Event. I agree that it is my sole responsibility to determine whether I am sufficiently fit and healthy enough to participate in the Event.
2. I understand and acknowledge the physical and mental rigors associated with triathlon, duathlon, or other multi-sport events, and realize that running, bicycling, swimming and other portions of such Events are inherently dangerous and represent an extreme test of a person’s physical and mental limits. I understand that participation involves risks and dangers which include, without limitation, the potential for serious bodily injury, sickness and disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; accidents, contact or collision with other participants, spectators, vehicles or other natural or manmade objects; dangers arising from adverse weather conditions; imperfect course conditions; water, road and surface hazards; equipment failure; inadequate
safety measures; participants of varying skill levels; situations beyond the immediate control of the Event Organizers; and other undefined risks and dangers which may not be readily foreseeable or are presently unknown (“Risks”). I understand that these Risks may be caused in whole or
in part by my own actions or inactions, the actions or inactions of others participating in the Event, or the acts, inaction or negligence of the Released Parties defined below, and I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or expenses
which I incur as a result of my participation in the Event.
3. I agree to be familiar with and to abide by the Rules and Regulations established for the Event, including but not limited to the Competitive Rules adopted by USAT and the Guide to Prohibited Substances and Prohibited Methods of Doping adopted by the United States Anti-Doping Agency.
I also accept sole responsibility for my own conduct and actions while participating in the Event, and the condition and adequacy of my equipment.
4. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: USAT, the Event Owners, Organizers and Promoters, Race Directors, Sponsors, Advertisers, Host Cities, United States Olympic Committee (USOC), Local Organizing Committees, Venues and Property Owners upon which the Event takes place, Law Enforcement Agencies and other Public Entities providing support for the Event, and each of their respective parent, subsidiary and affiliated companies, officers, directors, partners, shareholders, members, agents, employees and volunteers (Individually and Collectively, the “Released Parties” or “Event Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court costs and reasonable attorneys fees) of any kind or nature (“Liability”) which may arise out of, result from, or relate to my participation in the Event, including claims for Liability caused in whole or in part by the negligence of the Released Parties. I further agree that if, despite this Agreement, I, or anyone on my behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liability which
any may be incurred as the result of such claim.
I hereby warrant that I have read this Agreement carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal rights by signing it (including the rights of the minor, my spouse, children, parents, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns), acknowledge that I have signed this Agreement freely and voluntarily, without any inducement, assurance or guarantee, and intend for my signature to serve as confirmation of my complete and unconditional acceptance of the terms,
conditions and provisions of this Agreement. This Agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.
I understand that the participation fee is non-refundable and the Event organization and authorities involving in this event has the right to make any changes including time, schedule and cancellation without refund, in any case of emergencies such as natural disaster and any other emergencies. I consent and will give all authorities and copyright to the Event organization for the use of photography, motion pictures, recordings or any other record of this event for the legitimate purposes use in TV, Radio, Newspaper, Magazines, Internet and any Media publishing. I understand that the race T-shirt was ordered at the time of application form acceptance and will be given out to each participant and the size of the T-shirt is not a guarantee and may not be my desired size. I understand to get the event packet on pick up day and to pick up my desired size t-shirt. I also waive/release any responsibilities regards to the Event organization for any lost and theft during the event.
Relay Team leaders agree to the waiver for all other team members in their team.
By submitting this application electronically, I agree all information is correct and to abide by the USAT Competitive Rules.

COVID-19 Section - Please read carefully:
I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov. I assume all such risks being known, appreciated, and accepted by me.  
I acknowledge the contagious nature of COVID-19 and other communicable diseases and voluntarily assume the risk that I may be exposed to or infected by COVID-19 and/or other communicable diseases by participating in this event. I acknowledge that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my participation in this event and personally assume this risk.

I have read this agreement and fully understand its terms. I understand that I have given up substantial rights by signing it, and sign in it freely and voluntarily without any inducement.

Digital Signature of Participant (Type your full name here)

PARTICIPANTS UNDER THE AGE OF 18 ARE REQUIRED TO HAVE PARENT SIGN: This is to verify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, release and agree to indemnity and hold harmless the Releases from any and all liabilities incident to my minor child's involvement of participation in the events as provided above, even if arising from their negligence.

Digital Signature of Parent Or Guardian (only required if the participant is under the age of 18)

	Item	Qty	Subtotal
	Photo Package (?) Get all pictures taken of you during the event at a discounted price (normal price is $29.95)! $19.95		$0.00
	Subtotal for extra items: