OPEN TO THE PUBLIC 20 15 Saturday, May 2, 2015 7:00 AM • Starts @ K-Bay Base Pool 7 to 10 Year Olds: 50-Meter Swim / 2-Mile Bike / 0.8-Mile Run 11 to 14 Year Olds: 200-Meter Swim / 4-Mile Bike / 1.2-Mile Run Individuals $25 / $10 late entry after Apr 24 Includes shirt, bib # and finisher medal For more info call 254-7590 REGISTER & PAY ONLINE! (Online Registration Closes Apr 28] www.mccshawaii.com/races SEMPER FIDELIS MARINE CORPS BASE HAWAII No USMC or Federal Government endorsement of sponsors. KEIKI Koa Kai Sprint Tri Check in PACKET PICK-UP At 5:00 AM the Keiki Koa Kai Sprint Tri will start at the Base Pool. The event begins at 7:00 AM. Pick-up will be at the K-Bay Front Gate (Civilians), April 30 from 12:00 PM - 5:00 PM; and at the K-Bay Semper Fit Center (Military) on Friday, May 1 from 10:00 AM - 4:00 PM. and the morning of the race. TRIATHLON 7 to 10 Year Olds: 50-Meter Swim / 2-Mile Bike / 0.8-Mile Run. 11 to 14 Year Olds: 200-Meter Swim / 4-Mile Bike / 1.2-Mile Run. SAFETY FEES & REGISTRATION Individuals: $25. Late fee of $10 assessed for registration after Apr 24. Price includes shirt, bib # and finisher medal. Shirts and finisher medals are not guaranteed, if registering after Apr 24. Online payment and registration is available at mccshawaii.com/races until April 28. Make checks payable to MCCS 0910. Walk-in registration is accepted at the Semper Fit Center reception desk, Bldg 3037. Call 254-7590 for more information. PLEASE PRINT CLEARLY IN INK & COMPLETE FULLY Safety is our #1 concern. Road guards and medical personnel will be posted at various points throughout the race course. Participants are responsible for their own physical condition. Bike inspections will be held at the bike staging area, by the transition area. They will be provided from 5:30 AM - 6:30 AM prior to the start of the race. Bicycle helmets must be worn by all cyclists. Bicycle repair kits are highly recommended. • Children must be able to swim in 12 ft water on their own. We will have multiple lifeguards on site. AWARDS: All Children will receive a participation award. ENTRY FORM NAME OF CHILD:___________________________________________________________ PHONE______________________________ GENDER____ AGE_____ SHIRT SIZE*_____ *SHIRT SIZES: S M L XL (ALL CHILDREN SIZES) Parent/Guardian NAME:_______________________________________ EMAIL:___________________________________DRIVER’S LICense:________________ (needed to gain base access) ENTRY FEE: INDIVIDUAL $25 LATE ENTRY FEE (after April 24): INDIVIDUAL $10 CHECK T-SHIRT SIZE: S___ M___ L___ XL___ TOTAL ENCLOSED $_______________________ MAKE CHECKS PAYABLE TO: MCCS 0910 All checks must have Name, Current Address, Two Phone Numbers and Rank (if applicable) MAIL TO: MCB HAWAII • BOX 63073 • KANEOHE BAY, HI 96863-3073 • ATTN: ATHLETICS/FITNESS HOLD HARMLESS AND WAIVER OF LIABILITY AGREEMENT HOLD HARMLESS AND WAIVER OF LIABILITY AGREEMENT (must be signed) In consideration for me and/or my son/daughter to participate in the Marine Corps Community Services (MCCS) Keiki Koa Kai Sprint Triathlon at Marine Corps Base Hawaii, (hereinafter called event), I hereby take the following actions for myself or anyone else who might claim or sue on my behalf: (a) I acknowledge that the event includes running, swimming and cycling activities and is an arduous test of a person’s physical and mental limits and carries with it the potential for death, collision, serious injury and property loss; (b) I acknowledge that certain detrimental physiological changes may occur while I participate in the event, including but not limited to heat exhaustion and stroke; abnormal heart beat; abnormal blood pressure; and, in rare instances, heart attack; (c) I acknowledge that there may be other participants in the event and that their actions may be unpredictable; (d) I certify that I am physically fit and have not been advised against participation in the event by a qualified health professional; (e) I agree that, prior to participating in the event, I will inspect the event facilities, equipment, and areas to be used and if I believe any are unsafe, I will immediately advise a person supervising the event; (f) I assume all risks associated with the event, including, but not limited to adverse road conditions; falls; contact with other participants, effects of weather, my personal physical condition; motor vehicles on the event course; and lack of hydration; and (g) In connection with the event, I forever release from all liability under the Federal Tort Claims Act, acquit and discharge from all known obligations, losses, damages, liabilities, injuries, claims, demands, actions, causes of action and expenses, including without limitation, attorney’s fees and costs, the following persons or entities: United States Government including MCCS and the United States Marine Corps, and the employees, representatives, sponsors and agents of the above. (h) I further grant full permission to the United States Marine Corps and Marine Corps Community Services to use any photographs or media taken by MCCS of me (or my child) for any purposes. I understand that I do not own the images and no further payments are due to me in regards to them. Signature Date Parent/Guardian Signature (must be signed) Date
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