Saturday, November 13, 2010
2015 Triple D Registration & Release Form
Registration is now open for the Triple D Winter Race: http://tripled.athlete360.com/
The famous Triple D Winter Race (since 2007), Oh, what fun we've had!
Important Dates & Times
1. Hotel Reservations under our Group rate at the BEST WESTERN PLUS DUBUQUE HOTEL & CONFERENCE CENTER. Please reference “Triple D Winter Race” when making reservations. If you want to share a room let me know and I’ll get you hooked up with other racers. DO NOT WAIT as we have book our hotel three years in a row.
2. Registration Data (see below)
3. Race Day Check in / Race Packet pickup at 8-9 am on Race Day for out of town racers, Saturday (the day before the Sunday race) will be the required Race Packet pickup and Check-in for local racers and those who can make it Saturday.
4. Prerace Meeting for runners and Skiers 9:05 am on Race Day
5. Prerace meeting for Bikers at 9:30 on Race Day
6. Race Start 10 AM sharp from all three starting lines simultaneously.
7. Bikers: Recommended finish no later than 10 pm (not mandatory but you’ll miss all the fun if you arive later than 9:30 pm).
8. Runners/ Skiers will have awards at their respective finish lines this year, but are more than welcome back at the event headquarters for a presentation of awards for the entire group and party.
We also now have online registration at http://tripled.athlete360.com/ to make things easy, however if you want to save a couple $ you can do it by USPS.
Name of Participant:
Race Cell Number:
Mail Registration information and $60 check ($45 for the Poker Ride) to:
Triple D Race c/o Lance Andre
1735 Eden Lane
Dubuque, IA 52001-4027
================= RELEASE FORM =========================
Triple D Winter Race Application & Waiver
NOTICE: This application and Release Form is a contract with legal consequences. Please read it carefully before signing it. Racers in the Triple D Winter Race must be at least age 18 years by the day of the event unless prior approval by personal interview with the man.
Name: ______________________________________ Age: _______ Sex: _____
Estimated Race Category* (circle one):
Ultramarathon Bike - 100+ km (No DNFs, you simply become a Poker Rider)
Ultramarathon Ski or Run - 50 km (Can drop at the Marathon Finish and still receive a finish time)
Marathon Ski or Run - 26.2 mi
Half Marathon Ski or Run - 13.1 mi
Poker Ride - Whatever distance you make it
* Category can be changed on race day, but please mark what you think you will be doing as this helps schedule transportation requirements.
Address: _________________________________________ City: ____________
State: _______________________ ZIP: _______________
Home Phone: __________________ Race Cell Phone: _____________________
For ($10 extra) Shirt Size: S M L XL 2XL (Long Sleve Dri Fit)
I have competed in Winter Racing before*: Yes / No (circle one)
* You will still be allowed to race, just need to know your experiance for our sag crew...
If Yes, Event and Distance: ___________________________________________
I have competed in ultras (beyond 6 hours): Yes No (circle one)
If Yes, Event and Distance: ___________________________________________
In consideration of the acceptance of my application for entry in the Triple D Winter Race, I hereby freely agree to make the following contractual representations and agreements: I fully realize the dangers of participating in a winter skiing / bicycling / running / snowshoeing races held in the remote Iowa wilderness during extreme winter conditions, and fully assume the risk associated with such participation, including but not limited to the following dangers: hypothermia, frostbite, collision with pedestrians, vehicles, wildlife, and other racers and fixed or moving objects, dangers arising from surface hazards, equipment failure, inadequate safety equipment, weather conditions, and animals and the possibility of serious physical and/or mental trauma and injury, including death, associated with winter athletic competition.
I hereby waive, release and discharge myself, my heirs, executors, administrators, legal representatives, assigns and successors in interest (hereafter collectively "successors") any and all rights and claims which the sanctioning organization, the promoter and any promoting organization(s) and their board of directors, property owners, law enforcement agencies, all public entities, special districts, and properties (and their respective agents, officials and employees) through or by which the event will be held for any and all damages which may be sustained by my participation in of associated with the event, or travel to or return from the event.
I agree it is my sole responsibility to be familiar with the race course, the rules of the sanctioning body, and the special regulations of the event. I understand and agree that the situations may arise during the race which may be beyond the immediate control of the race officials or organizers, and I must ski, bicycle, run, or snowshoe so as to endanger neither myself nor others. I accept responsibility for the conditions and adequacy of my equipment and training. I have no physical or mental condition which, to my knowledge, would endanger myself or others if I participate in this event, or would interfere with my ability to participate in this event.
I agree that it is at the sole discretion of the race directors to change the rules at any time in the interest of safety and sportsmanship or for any reason deemed appropriate by the Triple D Winter Race officials, and I agree to abide by those rules. I understand that the race officials may pull any participant out of the event in the interest of the community, law, safety, time, sportsmanship; due to suspicion of cheating, acts of nature or any reason deemed appropriate by the Triple D Winter Race officials.
I agree, for myself and successors, that the above representations are contractually binding, and are not mere recitals, and that should I or any of my successors assert any claim in contravention of this agreement, I or my successors shall be liable for the expenses (including legal fees) incurred by the other party or parties in defending, unless the other party or parties are finally adjusted liable on such claims for willful and wanton negligence. This agreement may not be modified orally, and a waiver of any provision shall not be construed as a modification of or as consent to another provision herein of as a consent to any subsequent waiver of modification.
SIGNATURE OF ENTRANT
PARENT OR GUARDIAN OF A MINOR: I, as a parent or guardian of the above named minor, hereby give my permission for my child or ward to participate in the event, and further agree, individually and on behalf of my child or ward, to the terms above.
SIGNATURE OF PARENT OR GUARDIAN OF MINOR
For preapproval of a minor please call (563) 543-2784.
Minor approved by Triple D Race Director: Yes / No (circle one)
SIGNATURE OF TRIPLE D RACE DIRECTOR
Emergency contact: ________________________________________
Emergency contact in Dubuque vicinity for race: Yes / No (circle one)
Address: ____________________________ City: _______________
State: _________________ ZIP: ___________
Home Phone: ________________ Cell Phone: __________________