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VALLEY PAIN SPECIALISTS
DECK AT VALLEY
ABOUT US
Meet Our Managers
Membership Plans
Guest Policies & Forms
Employment Opportunities
Club photographs
NEWSLETTERS
FITNESS
Group Fitness Class Descriptions
Meet Our Personal Trainers
Indoor Triathlon
AQUATICS
Swim Lessons
Cabana Rental Request
Aquatic Policies
GREEN ROOM SALON & SPA
GRSS Menu
GRSS Hours
Appointment Cancellation Policy
KIDS & FAMILY
Family Hours
Birthday Parties
Junior Fitness Schedule
WELLNESS
Wellness Cafe
Chiropractic Care
Nutrition
SCHEDULES
Group Exercise Schedule
Cycling Schedule
VWC Event Schedule
FORMS
Indoor Triathlon Registration Form
Steven Mortazavi
2018-12-21T17:14:31+00:00
Url
First Name
*
Middle Name
Last Name
*
Age on 12/31/21
*
Weight (lbs)
*
Sex
*
Female
Male
Phone Number
*
Email Address
*
Address
*
City
*
State
*
- Select Province/State -
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
====================
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
First Triathlon Race?
*
Yes
No
T-Shirt Size
*
S Mens
M Mens
L Mens
XL Mens
XXL Mens
S Ladies
M Ladies
L Ladies
XL Ladies
XXL Ladies
Race Fees
*
$20 (12-17 member)
$25 (Adult VWC Member)
$35 (ALL NON MEMBERS OF VALLEY WELLNESS CENTER MUST PAY $35)
By typing my name below I verify that I have read the triathlon registration form and waiver. I am authorizing Valley Wellness Center to charge my account on file the registration fees checked above and release VWC from liability as explained in the participation waiver
Total Race Fee
*
Total:
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