Download entry form below in PDF format and print them out from your computer. Send it to the address on the entry form along with your entry fee and/or donation.

• Download 2012 Entry Form (PDF)
  

I WAIVE MY LEGAL RIGHTS:
I take sole responsibility for myself and my possessions during
the ride and it’s related activities. I acknowledge and agree
to the full extent permitted by law that the ride organisers,
Benalla Triathlon Club, local councils, Tatong Tavern, Vic
Roads, sponsors, Capability Building Inc, state bodies and
employees or subcontractors of these agencies shall not in any
circumstances be liable in contract, tort or otherwise to me, my
heirs and successors for any loss, damage or personal injury
suffered directly or indirectly from any act of omission of the
above parties.
I AM MEDICALLY FIT TO PARTICIPATE:
I recognise that the ride is difficult. I am physically fit to
participate and I have no knowledge to the contrary.
I WILL OBEY THE RULES:
I will obey the Road Rules. I will abide by the rules of the ride
and related activities. I will obey the lawful directions of those
in authority during the ride.
I CONSENT TO MEDICAL TREATMENT:
If I cannot decide for myself at the time, and I am injured or
fall ill during the ride and it’s related activities, I consent to
receive any medical treatment which is deemed advisable.
I CONSENT TO MEDIA USE:
I consent to the publication and/or use in any form of media
of my name, image or statements in any context pertaining
to the ride or otherwise before, during and after the event for
any reason.
Please check the agreement on the order form.

After submitting your entry form you should be automatically sent to the payment section to pay for your ride.