Date of Birth:

USAT Membership #:

Last Name:

First Name:

Sex:

Street Address:

City, State, Zipcode:

Email Address:

Phone Number:

T-Shirt Size:

Seeding information:

Estimated Swim Time (750m):

Estimated Finish Time (750m/20k/5k):
To Complete your entry, please scroll down, read and accept the
waiver, then hit the submit button to reach the payment page.
2010 USAT Waiver
WARNING: READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF
LEGAL RIGHTS AND DEPRIVES YOU OF THE RIGHT TO SUE USA TRIATHLON AND OTHER PARTIES.
DO NOT SIGN THIS AGREEMENT UNLESS YOU HAVE READ IT IN ITS ENTIRETY. SEEK THE ADVICE OF
LEGAL COUNSEL IF YOU ARE UNSURE OF ITS EFFECT.
WAIVER AND RELEASE OF LIABILITY,
ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
IN CONSIDERATION of USA Triathlon (“USAT”) allowing me to participate in any USAT sanctioned event
(the “Event” or “Events”) as either a member of USAT or through the issuance of a single event license or
permit; I, for myself, and on behalf of my spouse, children, parents, guardians, heirs and next of kin, and
any legal and personal representatives, executors, administrators, successors and assigns, hereby agree
to and make the following contractual representations pursuant to this Waiver and Release of Liability,
Assumption of Risk and Indemnity Agreement (the “Agreement”);
1. I hereby represent that (i) I am in good health and in proper physical condition to participate in the Event;
and (ii) I am not under the influence of alcohol or any illicit or prescription drugs which would in any way
impair my ability to safely participate in the Event. I agree that it is my sole responsibility to determine
whether I am sufficiently fit and healthy enough to participate in the Event.
2. I understand and acknowledge the physical and mental rigors associated with triathlon, duathlon, or other
multi-sport events, and realize that running, bicycling, swimming and other portions of such Events are
inherently dangerous and represent an extreme test of a person’s physical and mental limits. I understand
that participation involves risks and dangers which include, without limitation, the potential for serious bodily
injury, permanent disability, paralysis and death; loss or damage to property; exposure to extreme
conditions and circumstances; accidents, illness, contact or collision with other participants, spectators,
vehicles or other natural or manmade objects; dangers arising from adverse weather conditions; imperfect
course conditions; water, road and surface hazards; equipment failure; inadequate safety measures;
participants of varying skill levels; situations beyond the immediate control of the Event Organizers; and
other undefined harm or damage which may not be readily foreseeable, and other presently unknown risks
and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by my own actions
or inactions, the actions or inactions of others participating in the Event, or the acts, inaction or negligence
of the Released Parties defined below, and I hereby expressly assume all such Risks and responsibility for
any damages, liabilities, losses or expenses which I incur as a result of my participation in the Event.
3. I agree to be familiar with and abide by the Rules and Regulations established for the Event, including
but not limited to the Competitive Rules adopted by USAT and the Guide to Prohibited Substances and
Prohibited Methods of Doping adopted by the United States Anti-Doping Agency. I also accept sole
responsibility for my own conduct and actions while participating in the Event, and the condition and
adequacy of my equipment.
4. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold
Harmless the following parties: USAT, the Event Organizers and Promoters, Race Directors, Sponsors,
Advertisers, Host Cities, Local Organizing Committees, Venues and Property Owners upon which the Event
takes place, Law Enforcement Agencies and other Public Entities providing support for the Event, and each
of their respective parent, subsidiary and affiliated companies, officers, directors, partners, shareholders,
members, agents, employees and volunteers (Individually and Collectively, the “Released Parties” or “Event
Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or
expense (including court costs and reasonable attorneys fees) of any kind or nature (“Liability”) which may
arise out of, result from, or relate to my participation in the Event, including claims for Liability caused in
whole or in part by the negligence of the Released Parties. I further agree that if, despite this Agreement, I,
or anyone on my behalf, makes a claim for Liability against any of the Released Parties, I will indemnify,
defend and hold harmless each of the Released Parties from any such Liability which any may be incurred
as the result of such claim.
I hereby warrant that I have read this Agreement carefully, understand its terms and conditions,
acknowledge that I will be giving up substantial legal rights by signing it (including the rights of the minor, my
spouse, children, parents, guardians, heirs and next of kin, and any legal and personal representatives,
executors, administrators, successors and assigns), acknowledge that I have signed this Agreement freely
and voluntarily, without any inducement, assurance or guarantee, and intend for my signature to serve as
confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this
Agreement. This Agreement represents the complete understanding between the parties regarding these
issues and no oral representations, statements or inducements have been made apart from this
Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable,
then that provision shall be deemed severable from this Agreement and shall not affect the validity and
enforceability of any remaining provisions.


Additional Considerations:

1.         In submitting this entry, and as an express condition of entry, I waive, release, and forever discharge
Happy Valley Sprint Triathlon, Nittany Multisport Inc., Scott C. Etter, Paul L. Fritzsche, and Megan K.
Schuchert, and The Pennsylvania State University, Patton Township, and Benner Township, and each of
their respective employees, agents, and assigns (“Released Parties”) for and from any and all injuries,
losses, or other damages suffered by me at this event, while traveling to and from this event, or while
participating in this event.

2.         To the extent that my child or ward is under the age of 18, in submitting this entry and as an express
condition of entry, I agree to indemnify and hold Released Parties harmless from and against any and all
claims or demands, including reasonable attorneys’ fees, made by my child or ward due to or arising out of
my child or ward’s participation in this event.

3.         I acknowledge that participation in this event poses risks for my child or ward, and/or for me and I
represent that my child or ward or I is physically able to participate in this event, and has trained sufficiently
to do so.  I authorize my child or ward to be treated by a licensed physician, EMT, registered nurse, or
athletic trainer, if necessary, while participating in this event.

I hereby warrant that I have read this Agreement carefully, understand its terms and conditions,
acknowledge that I will be giving up substantial legal rights by signing it (including the rights of the minor, my
spouse, children, parents, guardians, heirs and next of kin, and any legal and personal representatives,
executors, administrators, successors and assigns), acknowledge that I have signed this Agreement freely
and voluntarily, without any inducement, assurance or guarantee, and intend for my signature to serve as
confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this
Agreement. This Agreement represents the complete understanding between the parties regarding these
issues and no oral representations, statements or inducements have been made apart from this
Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable,
then that provision shall be deemed severable from this Agreement and shall not affect the validity and
enforceability of any remaining provisions.


Please verify your acceptance of the terms of the waiver by completing the following:
Participant's full name:

Today's Date:

Type "I agree":

As the Parent and/or Legal Guardian to the minor identified above, I hereby accept and agree to all of the terms and
conditions of this Agreement In connection with the minor’s participation in the Event(s). If, despite the Agreement, I, or
anyone on the minor’s behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend
and hold harmless each of the Released Parties from any such Liabilities which any may be incurred as the result of
such claim.

PARENT/GUARDIAN SIGNATURE (ONLY required if participant is under the age of 18):
Parent/Guardian Full Name:

Today's Date:

Type "I agree":
Clicking on the "Submit" button should take you to a page where you can process an online
payment through PayPal.  If that does not work, you can either:
Mail a check for your entry and any applicable USAT one-day fees to:

Paul Fritzsche
237 W Park Ave
State College, PA 16803

Make checks payable to "Nittany Multisport, Inc"

OR

Log in to your PayPal account and "Send Money Online" to send the appropriate
amount to:

Paul@Triathlete.com
Please Note:  This form is ONLY for athletes who are annual members of USA Triathlon.  
Those who are not members will need to pay a $10 "one-day licensing" fee to cover their
insurance, etc.