Triathlons - BASF Smile Train Triathlon

Individual Participant - Registration

If you are on a Relay Team do not use this form. Please register at this page.

The Items below with an "*" are required before registration can be completed.

After you submit this form you will be directed to make payment online. If you are not prepared to submit payment or do not submit payment we will automatically cancel your registration.


First Name	*
Last Name	*
Middle Initial
Address	*
City	*
State	*
Zip	*
Email	*
Date of Birth - MM/DD/YYYY	*
Age on December 31, 2008	*
Sex	*
Phone - Include Area Code	*
Are you a USAT Member?	*
USAT Member # - if applicable
Type of Entry	*
Estimated 100 Meter Swim Example: 05:20 = 5 Min. 20 Sec.	*
Bike Type	*
T-Shirt Size	*
How did you hear about us?	*

Have you read and agree to our Waiver? Read it here.	*	Yes
Initials of athletes over 18 years of age or parent/legal guardian of minor under 18 years of age or legal guardian of incapacitated and/or mentally challenged person.	*	Initials
In order to complete registration, you must by law be 18 or older. By checking this box, I agree that I am 18 or older.	*	Yes