| Membership Type |
|
| Payment System |
|
Your Name
Your First & Last name |
|
Your E-Mail Address
to you at this address
|
|
Date of Birth
*
Your Date of Birth |
|
Male / Female
*
Gender |
|
TI Number 2012
*
All members of Trilogy Triathlon must also be members of Triathlon Ireland (Full, Junior or Associate) |
|
| Address Line 1
*
|
|
| Address Line 2
*
|
|
| Address Line 3
|
|
| Address Line 4
*
|
|
Mobile Number
*
Format of 3538XXXXXXXX |
|
Volunteering - Races
*
As a member, you agree to help at TWO of the following races. Please select the races you can help at (you may change later). |
|
Season Goal 2012
Be Brave. Tell us your goal for 2012 (10 words or less!) |
|
Favourite Tri Websites
Your Favourite source for Tri Information on the web (aside from trilogy.ie!) |
|
Why do you Tri?
What do you like most about Triathlon? |
|
TI Login 2012
Your 2012 username for Triathlon Ireland |
|
TI Password 2012
Your password for Triathlon Ireland |
|
Country of Origin
*
Country where you were born |
|
T-Shirt Size
Please enter the t-shirt size you normally choose at races |
|
750m Swim Time
In Mins & Secs, please give an estimate of your time to swim 750m. This will be used for entry to Olympic races |
|
1500m Swim Time
In Mins & Secs, please give an estimate of your time to swim 1500m. This will be used for entry to Olympic races |
|
Next of Kin Name
Please enter the name of your Next of Kin |
|
Next of Kin Phone
*
Please enter the phone number of your Next of Kin |
|
About You
If you would like to list a link to a Facebook, Bebo or other personal website, insert the link here |
|
Choose a Login Name (User ID)
It must be 4 or more characters in length and may
only contain small letters, numbers, and
the underscore '_' |
|
Choose a Password
Must be 4 or more characters |
|
Confirm your password *
Enter password again |
|
Enter Verification Text
Please type text from image |
|
