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Kill Creek Park Triathlon Manual Registration Form

  1. JCPRD logo

  2. Event*

    Choose event in which you will participate. Price will be based on date form is submitted to race management team. Please see web page for fee structure.

  3. Relays

    If you are part of a relay, ALL members of the relay will be required to fill out and sign a registration form.

  4. Are you a member of USA Triathlon?*

  5. Not a USAT Member?

    All athletes competing in this event must have a USAT membership including all team members. One day USAT membership is $15, annual memberships are $50. USAT form must be filled out on site and checks must be made out to USAT.

  6. T-shirt size (unisex adult)

  7. Electronic Signature Agreement*

    In consideration of your acceptance of this entry form, I hereby, for myself, my heirs, my executors and administrators, forever release and hold harmless the Johnson County Park & Recreation District (JCPRD), race directors, sponsors, coordinating groups, and any individuals associated with the event, their representatives, successors and assigns for any and all injuries suffered by me, or damage to property resulting from my participating in said event. I have been warned I must be in good health to participate in this event, and I have successfully completed the said events at or farther than the distances specified for the event. In addition, I understand that there is risk and danger incidental to entering a natural body of water. The body of water in this event is tested and compliant with the Kansas Department of Health and Environment requirements for water quality; however, I realize that natural occurrences may change water quality at any given time and I assume this risk. In filling out this form, I acknowledge I have read and fully understand my own liability and do accept these restrictions. NOTICE: By registering you hereby acknowledge JCPRD can and may photograph and/or video tape event participants and then use such images and/or participant names, without payment or any other consideration, for purposes of publicizing District parks, facilities, programs or services, or for any other lawful purpose. EVENT CANCELLATION POLICY: The Committee reserves the right to alter or cancel the event in case of inclement weather. No Refunds. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  8. Leave This Blank:

  9. This field is not part of the form submission.