I. MEMBER INFORMATION

* Date Your Membership Should Begin:
-- pick month -- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec -- pick day -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009

* First name:

* Last name:

* E-mail address:

* Address:
* City:
* State/Province:
* Zip/Postal Code:

* Primary Phone: () -
Work/secondary Phone: () -

Birth date:
-- pick month -- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year (YY):

Gender: Male Female

Emergency contact:
Relationship:
Emergency contact phone: ()-
Emergency contact alternate phone: ()-

Physician:
Physician phone: ()-

Medications currently taking:

Please list any serious illnesses, medical conditions, or physical limitations:

Have you had any sport-related injuries? If so, please describe:

How did you hear about Team Sheeper?

II. MEMBERSHIP TYPE AND REGISTRATION FEES

* Pick ONE membership type:

Payment for online registrations must be made by credit card.

* Card Type: --pick one -- Master Card VISA Discover Sorry, AMEX, others, not accepted.

* Name on the Card:

* Card Number:

* Expiration Date: -- pick one -- 1 2 3 4 5 6 7 8 9 10 11 12 -- pick one -- 2008 2009 2010 2011 2012 2013 2014

• Billing of monthly and quarterly memberships will be automatic each month or quarter.
• Annual membership is for January through December. Annual memberships purchased after January and before April 1 will be pro-rated.
• Quarterly memberships are for the calendar quarters (January to March, April to June, July to September, October to December). Quarterly memberships purchased mid-quarter will be pro-rated.
• Monthly memberships are for the calendar month. Monthly memberships purchased after the 7th of the month will be pro-rated.

III. WAIVER AND ACKNOWLEDGEMENT OF TEAM POLICIES

1. The sports of triathlon, swimming, cycling and running involve the extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury, and property loss. Member’s initialing of this paragraph acknowledges that member certifies that he/she is physically fit and has not been advised against participation in these sports by a qualified health professional.
Check here to acknowledge*: 

2. I understand the risks involved with training for and competing in the sports of triathlon, swimming, cycling and running, and agree to indemnify and hold Team Sheeper L.L.C., its employees and officers, the City of Redwood City, its employees and officers, and the Menlo Masters, its employees and officers, harmless from and against any and all liability for injury or property damage that may arise from any training or competition connected to the activities of the Team or Teams.
Check here to acknowledge*:

3. I acknowledge and agree to the team policies listed below.
Check here to acknowledge*: 

Date*: -- pick month -- Jan. Feb. Mar. Apr. May June July Aug. Sep. Oct. Nov. Dec. -- pick day -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2007

POLICIES:

• All members must know their physical condition and limits. There are risks involved when participating in intensive exercise. Participants are encouraged to have regular medical exams before and while engaging in this program.
• All membership payments are non-refundable, and are billed automatically on or around the first day of a month or quarter.
• Thirty (30) days written or email notice of termination is required to end automatic payments. Notice can be mailed to 501 Laurel Street, Menlo Park, CA 94025 or e-mailed to membership@teamsheeper.com. Thirty (30) days written or email notice is also required for changes to automatic payments. Notice for a change or cancellation must be given by the 1st of any month, in order to apply for the following month, since billings are done on the 1st day of every month. Once quarterly payments are made, they are non-refundable, despite the cancellation in the middle of a quarter. Upon cancellation, a payment for the next month is NOT prorated. The automatic transaction goes through as set up, unless TS is notified 30 days BEFORE that transaction is due to go through. A $25 reinstatement and/or change fee will be charged for memberships stopped and re-started, or for memberships put on hold for any period of time, or for other administrative changes made to memberships and membership type.
• All checks should be made payable to: Team Sheeper.
• Annual team fee will include meet registration fees for relays, annual social event and equipment for team as needed.
• Credit card payments will appear as a charge from Team Sheeper. Credit card information provided at time of registration will be processed on a quarterly or monthly basis depending upon type of membership. In the case of charges being declined, member will be invoiced for the amount due plus a late fee of $25.00.

Notes/Special Instructions:

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