AVAILABLE DATES
Please choose which discipline you would like to do, on which date (you can choose more than one activity on each date, but you must pay for each separate date) see payment information at bottom of the form)

Sunday August 4th 2019
80m Swim onlyFun swim only

Sunday August 18th 2019 FULL

OWNER INFORMATION

Your Name
First(required)

Surname (required)

Your Email (required)

Address
Street Address (required)

Address line 2

City (required)

Postcode (required)

Mobile Phone Number (required)

Emergency Contact Name - for on the day(s) you attend (required)

Emergency Contact Phone Number (required)

Details of any health issues relevant to attending the session & for on the day

Can you swim?
YesNo

Have you any previous open water swimming experience?
YesNo

You must wear a wet suit for the open water swim, do you have one?
YesNo

Do you wish me to organise a rental wet suite through TRI FARM?
YesNo

OWNER DISCLAIMER

Are you fit and well enough to undertake Tri Dog Training?
YesNo

Has your doctor advised you against participating?
YesNo

Do you accept 100% liability for any injuries, illness or death from participating? If answered No you will not be eligible to participate
YesNo

PET INFORMATION

Pet Name (required)

Breed (required)

Colour (required)

Age / DOB (required)

Sex
MaleFemale

Is your dog chipped
YesNo

Does your pet wear an ID Tag and collar?
YesNo

VETERINARY INFORMATION

Name of Veterinary Surgeon (required)

Address of Practice (required)

Veterinary Telephone Number(required)

Details of any health issues of your pet, relevant to attending the session & for on the day

Can your dog swim?
YesNo

Has your dog any previous open water swimming experience?
YesNo

Is your dog the minimum age for swim/canicross 12 months?
YesNo

Is your dog the minimum age for bikejor 18 months?
YesNoNot doing bikejor

Do you have a dog life jacket?
YesNo
WE STRONGLY RECOMMEND DOG LIFE JACKETS ARE USED.
As a minimum Dog Harness must be worn

DOG DISCLAIMER

Is your dog fit and well enough to undertake Tri Dog Training
YesNo

Has your vet advised you against participating?
YesNo

Do you accept 100% liability for any injuries, illness or death from participating? If answered No you will not be eligible to participate
YesNo

Additional Information (anything you feel relevant)

AGREEMENT TO ADHERE TO THE RULES OF THE DAY

By entering into our training event you are declaring to us, Tailrunners SE Essex Canicross Running Club and Amanda Stevens as the event organisers, that your dog is in good health and that the necessary vaccinations are up to date. In addition, you are confirming that your dog does not come from any disease area and from any area with veterinary traffic restrictions.

Due to the possibility of having to carry out overtaking manoeuvres, it is also particularly important that your dog is strong enough and well trained enough to avoid problems in overtaking.

In the case of an incident or accident, as the owner, you are responsible for your dog. , Tailrunners SE Essex Canicross Running Club and Amanda Stevens as the event organisers cannot be held responsible for any problems with third parties. Therefore, as the participant, you must ensure that you have taken out liability insurance for your dog.

You must also ensure that your dog is on-lead at all times on site.

By completing the form of participation, you are also confirming that you will follow the rules. Even if you have not read the regulations and participated you must accept this.

When participating in the Tri Dog training you, the participant, must take full responsibility for your health and your dog's health. Any rescue or rescue costs must be borne by you. Anyone who fails to comply with the regulations set forth in these regulations may be excluded from the event (even without warning), with a fee already paid.

Bitches only: do not bring a bitch in season

I accept the above rules of attending the event(s) (please tick)

The cost of attending each day is £10 (members) £15 (non-members)

I will make a payment below to secure my place after submitting the form (please tick)