Los Angeles Tri Club

Application

*Welcome, New Member!* *Dues:1 Year $70, 2 Years $110, 3 Years $150.* Please fill out the following information. You will be able to edit your profile/ information later. (please use caps and lower case) Privacy Note: In our Members Only section, other members will be able to see certain information that you choose to make available; use the Show and Hide buttons below. (non-members won't be able to see ANY contact info). If you would like to download and print this form then click here.
First Name:		*
Last Name:		*
Preferred Name:		*
Password:		*(Member can change. Must be at least four letters.)
Gender:		*
Birth Date:		Month: Day: Year: * (4 Digit Year)

USAT#:		http://www.usatriathlon.org/
Training Level:
Home Street:		* Show Hide
Home City:		*
Home State:
Home Zip:		*
Home Phone:		* Show Hide
Mobile Phone:		Show Hide
Fax Phone:		Show Hide
Email:		*
Emergency Contact Name:
Emergency Contact Relation:
Emergency Contact Phone:
All Business Info:		Show Hide
Occupation:
Business Name:
Business Phone:
Business Street:
Business City:
Business State:
Business Zip:
How Hear:		Category: Sub Category: Sub Category: Sub Category: More Info:
Referred By:
Volunteer:		Willing to volunteer?No Yes
Agreement:		Please take a moment to read over our club agreement. Click here to open.
Agree?		I agree to the terms outline in the LATC agreement.
Submit


	Mission Statement The LA Tri Club was established to provide a network of information, support services, training & racing activities, friendship and fun for all ages and abilities. The LA Tri Club is the largest tri club in the West with 1500 members. Check out our Join page for more details on our organization.

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