IRONMAN CAMP REGISTRATION FORM

Name *
Name
Name, relationship to you, contact mobile number
How many IM events have you completed?
Participant Waiver
THESE CONDITIONS ARE HERE TO ENSURE the camp is FUN AND SAFE for all involved - PLEASE READ ALL CONDITIONS below. By ticking the box at the bottom you have clearly understood expectations and agree to them. If you have any questions please contact Jenny to discuss.
I ACKNOWLEDGE THAT PARTICIPATION IN THE Ironman Camp CARRIES WITH IT POTENTIAL RISKS AND HAZARDS, I UNDERSTAND AND ACKNOWLEDGE THAT Swimming, BIKING and running activities carry RISKS RELATED TO environmental conditions, terrain and INTERACTION WITH OTHER ROAD USERS. THERE IS A REAL CHANCE OF SERIOUS INJURY, and or DEATH, FROM THESE RISKS AND HAZARDS. I TAKE RESPONSIBILITY FOR MY OWN WELL-BEING AND ACCEPT THAT I PARTICIPATE AT MY OWN RISK.
I understand that my contact details are included in the Traction Fitness and F3 Coaching database and that this database may be used for promotional purposes by Traction Fitness or F3 Coaching. I also agree that all images taken can be used for promotional purposes without my written approval.
FOR MYSELF, HEIRS, NEXT OF KIN, SUCCESSORS AND ASSIGNS HEREBY WAIVE AND RELEASE ANY AND ALL CLAIMS I MAY HAVE AGAINST TRACTION FITNESS, JENNY ROSE, F3 Coaching and Shane Reed ARISING OUT OF MY PARTICIPATION IN THE CAMP AND ASSOCIATED ACTIVITIES, TOGETHER WITH ANY COSTS INCLUDING ATTORNEY'S FEES THAT MAY BE INCURRED AS A RESULT OF ANY SUCH CLAIM WHETHER VALID OR NOT
We hope that you do not need to cancel however if you cancel at any time after payment you will receive a full refund minus an administration fee of $100. This fee covers event management costs. Cancellation will only be accepted on these terms if supported by a medical certificate from your doctor.
Agree to Participant Waiver *
CAMP FEE $375
Your position on the camp is confirmed after receipt of the camp fee
Account Payment Details
Bank: BNZ .......... ACCOUNT NAME: NJ ROSE ......... ACCOUNT NUMBER: 02 0828 0088647 000 ........... (Please ensure you clearly identify yourself on payment)