RCRC Olney | White Squirrel Kids Triathlon

First Annual White Squirrel Kids Triathlon

Friday / August 5, 2022

Musgrove Park & Aquatic Center

403 East Florence / Olney, Illinois

Family (Ages 3 to 8)

25 meter swim
(Parents can be in the water with child)

1/2 mile bike
(HELMETS REQUIRED)

1/4 mile run/walk

Parent/Guardian Participation Required

Sprint (Ages 9 to 12)

50 meter swim
(Parents can be in the water with child)

2 mile bike
(HELMETS REQUIRED)

1/2 mile run/walk

Iron (Ages 11 to 15)

150 meter swim
(Parents can be in the water with child)

3 mile bike
(HELMETS REQUIRED)

1 mile run/walk

Schedule of Events

Friday August 5th 2022
5:00 PM – 6:00 PM	Registration and Packet Pickup
6:00 PM	Race Start (Order : Iron -> Sprint -> Family)

REGISTRATION FEES

Free

RC Youth

$25

Non RC Youth

REGISTRATION FORM

If you would prefer to register offline then Download the Registration Form

Do you Qualify for a Richland County Youth Discount?*
- Yes
- No
Age Group*
- Family (Ages 3 to 8)
- Sprint (Ages 9 to 12)
- Iron (Ages 11 to 15)
Name
First Last
Birth Year
Shirt Size
Address
Street Address Address Line 2 City State ZIP Code
Gender
- Male
- Female
Email
Phone
Cell
Times Available
- Day
- Evening
Emergency Contact Name
First Last
Emergency Contact Phone
Waiver and Release
RCRC WHITE SQUIRREL KIDS TRIATHLON WAIVER AND RELEASE In consideration of acceptance of my child’s entry, I understand and agree that • I am voluntarily participating in the RCRC White Squirrel Kids Triathlon and have read and agree to comply with all rules, regulations, and event instructions. • I fully understand that my participation in the RCRC White Squirrel Kids Triathlon could result in serious injury to me or my child, including death. • I fully assume all risks and desire to participate without regard to those risks. I certify that I and any other participants that I am registering are physically fit and have sufficiently trained for participation in this event. • I, the undersigned, intending to be legally bound, hereby for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages I may have against the City of Olney, all event sponsors, organizers, volunteers, and representatives and their families from any and all claims and liabilities of any kind suffered by me or my child in conjunction with this event, including pre- and post-event activities. • I further indemnify and hold harmless the City of Olney, its officers and employees from any and all claims or lawsuits resulting from personal injury, including death, or property damage arising from or in any way connected to the special event; excepting any claims arising solely out of the negligent acts of the City, its officers and employees. • In the event that I am in need of medical treatment and unable to give consent to the employees or agents of Carle Richland Memorial Hospital, Carle Richland Memorial Ambulance Service and such other medical personnel that are on hand, such medical personnel are authorized to provide me with emergency medical treatment they deem necessary. • I also give permission for the free use of my name and/or pictures or video in any broadcast or any account of this event.
Signature of Parent/Guardian of Participant under 18
Date
Date Format: MM slash DD slash YYYY
Payment Details
Payer Name
First Last
Payer Email
Payer Phone
Payer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Payment Total
$ 0.00
Credit Card

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Card Number Expiration Date Security Code Cardholder Name
Total
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