If you like being active, being outside, and want to have fun, then join us this summer!

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1 Steamboat Youth Triathlon Club, brought to you by Old Town Hot Springs, has a new and exciting look designed to bring you more personalized coaching! With a start date of Monday June 11 th, this 7-week program will introduce youth participants to USA Triathlon and multisport racing. This program will bring a fun filled summer of swimming, biking, running, and learning triathlon skills from specialized coaches! The goal of the program is to have fun, learn more about multisport racing, and to improve fitness. With the new program design, we have optimized our time both in and out of the water, as well as improving overall safety for everyone. If you like being active, being outside, and want to have fun, then join us this summer! When: Mondays and Wednesdays, June 11 th -July 25 th There will not be practice on Monday, July 2 nd Year olds will meet from 9:45am-12pm -Bike/Run: 10am-11am -Swim: 11:15am-12pm 8-10 year olds will meet from 10:30am-12:30pm -Bike/Run: 10:45-11:45am -Swim: 12-12:30pm Who: Where: Cost: 8-13 year olds interested in Triathlon and multi-sport racing. Swim at Old Town Hot Springs; bike and run on Yampa Valley Core Trail, Yampa River Park soccer field, Steamboat Springs High School, and Spring Creek Trail. $185. Participant must be a member of Old Town Hot Springs. Must be a member of USA Triathlon Membership fee is $10. Registration fee includes all sessions and a T-Shirt. USAT membership is separate.

2 Equipment: Swim: Swimsuit, cap, goggles, towel Bike: Mountain/road bike, helmet, tennis shoes/bike shoes, water bottle holder on bike, shorts, t-shirt Run: T-shirt, shorts, tennis shoes Other: Water bottle, sunscreen, sunglasses Register: Please print and complete a registration form, health history/questionnaire, and liability waiver from the above URL or pick them up from the OTHS front desk. Return to desk when completed. - USAT Membership Mandatory Parents Meeting: Wednesday, June 6 th at 5pm at Old Town Hot Springs For more information please contact: Danielle Barrett, Fitness Assistant at Old Town Hot Springs (970) DBarrett@OldTownHotSprings.org

3 June 11-July 25, 2018 First Name: Last Name: Mom s Name & Phone: _ Dad s Name & Phone: Address: Address Line 2: City: State: Zip Code: Gender: Male Female Age: Emergency Contact Information: Name & Relation: Tel. #: USAT Member Number (teamusa.org/usa-triathlon): Size of Sport-Tek Raglan Jersey: Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Old Town Hot Springs Tri Club Member: $ (includes Team Shirt) **Child must be an Old Town Hot Springs member to register Cash Credit Check Signature of Parent/Guardian DATE: Please pick up and leave a signed registration form, health history/questionnaire, and waiver at the OTHS front desk.

4 Liability Release and Assumption of Risk for Old Town Hot Springs Youth Tri Club I,, hereby affirm that I have been advised and informed of the inherent hazards that may incur by participating in this pool/outdoor activity. I understand that I will be swimming in a pool, open water, biking, and running at my own risk. I understand and agree that Old Town Hot Springs and any of their respective employees may not be held liable or responsible in any way for any injury, death, or other damages to me that may occur as a result of my participation in this experience or as a result of the negligence of any party, including the Released Parties, whether passive or active. In consideration of being allowed to participate in this experience, I hereby save and hold harmless said program and I personally assume all risks in connection with this experience, for any harm, injury, or damage that may befall me while I am a participant in this experience, including all risks connected therewith, whether foreseen or unforeseen. I have fully informed myself of the contents of this liability release and assumption of risk by reading it before I signed it on behalf of myself and my heirs. Printed Name of Participant Date Signature of Participant Printed Name of Parent/Guardian Date Signature of Parent/Guardian

5 Athlete Health History + Questionnaire Name: Date: Gender: Male Female Birthday: Age: Height: Weight: Mom s Name: Cell: Dad s Name: Cell: Emergency Contact (Name, relation): Emergency Contact Number: Address: City: State: Zip Code: Are you a returning Youth Tri Club Participant: Yes No Medical History Personal Physician Name: Please list any medications taken on a regular basis (medication, frequency, dose, reason): Please list any allergies (to foods and/or medications): Please list any current illnesses, recent injuries, recent surgeries, or past medical complications:

6 Please circle any conditions you have, or have had previously: Heart Disease Heart Murmur/Surgery Asthma Wheezing ADD/ADHD Thyroid Problems Diabetes Epilepsy Anemia Stress Fractures Dizziness High or Low Blood Pressure (Circle which) Allergies Arthritis/Chronic Fatigue/Fibromyalgia Head/Neck Injury If so, please explain: Joint Injuries If so, please explain: Please list any other medical issues the coaches should be aware of: Fitness and Performance Goals On a scale of 1 to 5, where do you feel your fitness level is (1= low, 5= high): How many times a week do you exercise: What other sports do you participate in: Do you plan on racing in any triathlons this year: What do you hope to get out of joining the Youth Tri Club: What is your favorite part of triathlon training (bike, run, swim, social, etc.): If you have participated previously, what did you enjoy the most: If you have participated previously, what did you least enjoy: I have been in an organized swim program before: Y N I have been in an organized run program before: Y N I have done an open water swim before: Y N I have competed in a triathlon: Y N