Download & Print Entry Form
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.
Online Payments via Paypal Click here
Online payments accepted till 11:59pm on the 15/10/16, after that riders can pay on the day incurring a $10.00 surcharge.
WAIVER - All participants must read and agree
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, Benalla Newspapers Pty Ltd, 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 button on the order form.
PLEASE NOTE: After submitting your entry form you will be automatically sent to the payment page to pay for your Ride and T-shirt