USAT Insurance & Club T-shirt Information

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In order to enroll the club and activate the club insurance through USAT, MMTC needs to submit a roster of our members with some general information to include USAT #. MMTC will pay $0 per member who is a current USA Triathlon Annual Member and $5 per member who is a non-USA Triathlon Annual Member. To make sure we have paid the correct amount for our insurance and to activate it for coverage, PLEASE fill out the information below. Your prompt response is greatly appreciated.

Furthermore, we are about to put together a club shirt and will need an idea of the sizes we will need to order. Please select shirt size for unisex and gender specific.

THANK YOU!!

Name *

Email *

To which gender do you most identify? *

Female

Male

Transgender Female

Transgender Male

Gender Varient/Non-Conforming

Prefer not to Answer

Autre :

Birthdate

Are you under 18? *

Yes

If you are under 18, please list your MMTC parent/guardian or N/A. (SafeSport requirement) *

Are you a USAT member? *

Yes

Please enter your USAT # or N/A if you are not a member *

TShirt size selection if Unisex *

XXL

Autre :

TShirt - If gender specific sizes offered, please enter size preferred (example: M-L or F-XS) *

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