Somersault Promotions

To enter the Graham Beasley please follow these steps:

Type your name and other information into the web form below and click the submit button.
MasterCard and Visa are accepted. Your online Credit Card Transaction will be processed securely in CDN dollars and will show eventsonline.ca as the processor.
Confirmation of entry via this online form will be provided by email and on the confirmation page after your payment has been processed. (Payment processing takes about 16 seconds.)

	Up to December 31, 2009	Up to January 31, 2010	Up to March 15, 2010	Up to June 28, 2010	Up to July 4, 2010
EVENT	20% Discount	15% Discount	10% Discount	Regular Fee	Late Fee
Try A Tri	$44	$46	$49	$55	$63
Super Sprint Tri	$48	$51	$54	$60	$68
Sprint Tri/Du	$48	$51	$54	$60	$68
Sprint Tri/Du Relay	$74	$79	$83	$93	$103
Sprint SwimCycle	$44	$46	$49	$55	$63
Olympic Tri/Du	$56	$59	$63	$70	$78
Olympic Tri/Du Relay	$82	$87	$92	$103	$113
Olympic SwimCycle	$48	$51	$54	$60	$68
Half Iron 113 Tri/Du	$90	$96	$101	$113	$133
Half Iron 113 Tri/Du Relay	$98	$104	$110	$123	$143
Half Iron 113 SwimCycle	$67	$70	$74	$83	$93
2000M Swim	$31	$32	$34	$38	$43
Students born 1986 or later	40% off	40% off	40% off	40% off	40% off

SPECIAL PRICES
Students born in 1986 or later	40% Discount up to the Sunday before the event (online entries only!). Students born in 1986 or later are eligible for a student discount in most individual events. Please include the name of the institution you attended in 2009-2010 in order to be eligible for this discount.
60 Years & Over	10% Discount after March 15, 2010. Participants 60 & over receive an automatic 10% discount on individual event entry fees between March 15th, 2010 and Midnight July 4, 2010 (online entries only!).

NOTES
Online registration will close at Midnight on July 4, 2010. Registration fees after July 4, 2010 are by cash only and at a higher rate. See the race web site at http://www.somersault.ca/eventgrahambeasley.htm for late registration details. All entries are non-refundable and non-transferable. The entry fees listed above do not include the online processing fee. The entry fees listed above do not include the following event surcharges for event accreditation, officiating, safety, medical, and rising fuel costs. $4 for individual running events, $5 for individual tri/du events, and $8 for tri/du relay events. Find more information about certain fields by hovering over the Somersault "O".

MANDATORY FIELD = *

*Select Type of Entry:

*Participation Category:

*Walker?:

*Champions Challenge?:

*First Name:

*Last Name:

*Address:

*City:

*Province/State:

*Postal Code/Zip Code:

*Country:

*Day Phone number:

*Evening Phone number:

*Email address:

*Confirm Email address:

*Date of Birth: Year Month Day

*Age on December 31st, 2010:

*Gender:

Male
Female

*Souvenir Shirt - Size and Type?

School:

List any medical conditions:

Club Affiliate:

ChampionChip #:

How did you hear about the event?

Discount Code:

Lanark Health and Community Services
�Getting in Motion Fund� Donation: $ How does pledging and donating work?

Parent or Guardian Name:
(Entrants under 18 years of age)

WAIVER, RELEASE AND INDEMNIFICATION

Please accept my entry for the Graham Beasley. I acknowledge that I am participating at my own risk in this event and I agree to waive all claims of every nature against Christine McKinty, Terry McKinty, Somersault Promotions, and Somersault Promotions Ltd., Town of Carleton Place, Lanark County, Steve Wyrozub, Somersault Motorcycle Patrol Group, PECCO�s, Brockville Kayakers, Canadian Ski Patrol, and Search and Rescue Global 1, the event sponsors, Somersault Series sponsors, and any and all other participating individuals or agencies in respect to any and all personal loss or bodily injury, including death, resulting from my participation in this event. I acknowledge and understand that participation in this event involves risks to my health and safety, including death, and I willingly accept these risks. I further acknowledge and understand that insurance coverage for this event does not provide me with personal accident insurance benefits and that I am responsible to obtain my own personal accident insurance coverage should I wish to be eligible for accident benefits that are in excess of those currently covered through my provincial/state or private health insurance plan(s). I also acknowledge that I understand the rigors of this competition and I verify here that I know myself to be healthy and fit enough to participate in it. In providing my email for identification and communication purposes, I understand that my email may be used for Somersault newsletters, event updates, and sending photo proofs, and that Somersault will not sell its email lists to any third parties. I agree to permit the event organizers to use any photo taken of me during the event for promotional purposes on its website, in the media or in special promotions.

I agree to allow a link to individual photos taken of me by the official race photographer during the race, to be
placed beside my name on the official race results produced by SportStats:

I understand that the company listed on my credit card statement for
this event/transaction will be www.eventsonline.ca:

I have read and agree to the above waiver:

RELAY

FAMILY / GROUP

WAIVER, RELEASE AND INDEMNIFICATION