Questions in red are required for submission.

* 1. Name

* 2. Parents Name(s) and contact numbers

* 3. Email

* 4. Phone

* 5. Address

* 6. Age

* 7. DOB

* 8. Sex

Male  Female

This is required so that we may include you on our official USAT club roster.   9. USAT number

10. Are you a (check all that apply)

Triathlete  Runner  Duathlete  Road Cyclist  Mountain Biker  Other

11. Please breifly describe your competetive experience. Include placements, awards, and how long you have been competing.

12. Please list your performance metrics such as 5k/10k PR's, swim records, 40k TT, or others.

13. What is your main goal for next season? Please list a tentative race schedule.

14. What is your ulimate or "dream goal" as an athlete?