How Do I Join the Team (Full Ironman)

To join the Team Emily's Power for a Cure
2017 Ironman Chattanooga,
please do the following:
 
1. You have to be a registered 2017 Ironman Chattanooga participant
2. Fill in the form below to join
3. Look for an email from Wendy that will welcome you to the team.
 

EPFAC and the Chattanooga Ironman 2017

First Name 
Last Name 
Email Address 
Cell phone number 
Emergency phone number day of Ironman 
Birthdate (MM/DD/YY) 
Ironman confirmation # 
Training T-Shirt size 
I agree to the Terms and Conditions listed in the waiver/release below* 
To prove you are a human, please tell us which is wet?
 

Waiver/Release Team Emily's Power for a Cure/Ironman Release and Indemnification I agree, for myself, my heirs, executors, and administrators, to not sue and to release, indemnify and hold harmless Emily's Power for a Cure, its affiliates, officers, directors, volunteers, and employees, and all sponsoring businesses and organizations and their agents and employees, from any and all liability, claims, demands and causes of action whatsoever, arising out of my participation in this event and related activities - whether it results from the negligence of any of the above or from any other cause. Furthermore, I authorize the use, copyright, or publication of my name, image, or voice as may be captured by photograph or recording while participating in this event in any medium for any purpose, including illustration, promotion, or advertisement. Foregoing release and indemnification shall be as broad and inclusive as is permitted by the State in which the event is conducted. If any portion of it is held invalid, the balance shall continue in full force and effect.

I agree to raise at least $2,000 for The Emily's Power for a Cure Team participating in the 2017 Ironman Chattanooga.  Should I not obtain this amount through online/personal donations, I will pay the balance due so that I reach my goal of $2,000

In return, I will receive from Emily’s Power for a Cure; local team training for 7 months with Empirical Athletics owner/coach and (too many to count) Ironman participant, Andy Sweet, day after celebratory dinner, team training shirt, race day tri kit and prize for the largest fundraiser

I have read, understand and agree to the terms of this agreement. I hereby consent to my participation. I have read the foregoing release and indemnification agreement, and hereby agree to its terms. *

 

Welcome to the Team!

Site Sponsored by
Chattanooga Allergy Clinic
Emily's Power For A Cure - P.O. Box 1387 | Hixson, TN 37343 | powerforacure@gmail.com