VANUATU TRIATHLON ASSOCIATION
P.O.Box 1147 Port Vila, Vanuatu. Email: info@triathlon.com.vu

2007 MEMBERSHIP FORM

Name:   _______________________________________________________

 
Address: _____________________________________________________

Phone:  ______________________________________________________

Email: _______________________________________________________

I acknowledge that the events organised by the Vanuatu Triathlon Association (VTA) require a minimum level of health and fitness, for which I have suitably prepared, and also represent some element of risk for which I accept responsibility for my own personal safety. 
In accepting this membership I hereby release the event organisers, officers, volunteers and supporters from all claims of responsibility arising from my participation in VTA sanctioned events. 
I acknowledge that I understand the risks associated with my participation and that I have no physical or mental conditions that have the potential to place others or myself at risk.  I further agree to abide by the rules of the VTA and accept any decision made under them, and to consent to receive any medical treatment that may be deemed advisable. 

In the case of a family membership, I accept full responsibility for the safety of the participating members of my family.

Signed: _____________________________  Date: __________________

  (A parent or guardian is required to sign if the applicant is under 18 years of age)

Membership Fees:
Standard                                  500 vatu
Family                                    1000 vatu
Junior  (under 18)                      250 vatu