DuathlonRegistration

Pagosa Duathlon Registration Form

“Do-the-Du”
Saturday, July 14th, 2018
Dusty Kids Gravel Growler starts at 7:30am
All other races start at 8:15am
Join us for a fun race day anyone can ‘du’!

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Cell Number *

Age (day of race) *

Choose One *

Male Female

Address *

Line 1

Line 2

City

State

Zip Code

Country

Course *

Dusty Kids Dirty Sprint Dirty Du

Division *

Individual Team

Team Member’s Name *

If Team, what portion are you racing? *

Run Bike

Dusty Kids: 1 mile run & 2 mile bike ride
Dirty Sprint: 3 mile trail run & 8 mile mountain bike ride
Dirty Du: 6 mile run & 14 mile mountain bike ride

Division: Men’s Individual, Women’s Individual, 2-member Team (any gender combo)
Entry Fee Includes: Official Race T-Shirt, Food, Awards and other fun Prizes
***** Entry Fee is PER Person – Each team member must register and pay separate entry fee *****

Dusty Kids: $10
Dirty Sprint: Early Registration due by July 2 - $30 / July 3 to Race Day - $40
Dirty Du: Early Registration due by July 2 - $40 / July 3 to Race Day - $50
Shirt Upgrade – Upgrade to a dry wick, performance tee-shirt: June 11th deadline - $5
Student Discount: $10 off Adult Race Entry Fees (school ID required)
For complete race information click here

All proceeds benefit Rise Above Violence (Rise), a 501(c)3 nonprofit organization committed to ending domestic violence and sexual assault. Rise promotes the belief that all people have the right to live free from violence by providing 24-hour support and advocacy services for victims and education for youth and our community.

Please make checks payable to: Rise
Return entry form with payment to: Pagosa Duathlon, PO Box 2913, Pagosa Springs, CO 81147.

EVENT WAIVER:
I hereby release ACVAP DBA Rise Above Violence, the organizers and sponsors of this event from any liability due to injuries, illnesses or damages I may incur as a result of participating in the Pagosa Duathlon. And I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and hereby waive, release, discharge, indemnify and hold harmless the entities or persons responsible for hosting, sponsoring, volunteering or otherwise participating in the production and organization of this event. I am fully aware of the hazards of running and biking and accept full responsibility for my own safety. I do understand that proper equipment and helmets are REQUIRED to participate in this race. I understand if I do not wear a helmet, I will be disqualified from the race. I also understand and agree that the sponsors may subsequently use, without obligation or liability, my name or picture of me participating in this event. Parents assume all responsibility for youth competitors. Adult accompaniment of youth under 13 years of age is required. Older youth, parent accompaniment is recommended. All racers must complete and sign event waiver prior to race.

By signing below, I consent to the terms in the event waiver agreement.

Signature (Type Full Name) *

Parent’s Signature (if under 18 years) *

Submit