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Tri-City Triathlon Club Membership Application

[ ] General Membership = $25.00
Includes monthly newsletter and all weekend runs and rides

[ ] Complete Membership = $85.00
Covers general membership + track fees + pool fees

[] Family Membership = $125.00

Name:______________________________________________

Address:____________________________________________

City:_________________________________Zip___________

Home Phone:_________________Work Phone:_____________

E-mail Address:______________________________________

Release of Liability:
In consideration of the acceptance of my membership in the Tri-City Triathlon Club, I the undersigned, intending to be legally bound, do hereby waive and release forever any and all rights and claims for damage and demands I may accrue against the club, sponsors, officers and persons within these organizations for any injury suffered by me while traveling to or from and causes of action from our out of my particpation in this club.

_______________________________    ___________________
Signature (Parent or Guardian if under 18)              Date

Total $ enclosed_______________________________________

Make checks payable to: Tri-City Triathlon Club, 5364 Silver Reef Dr., Fremont CA 94538