Request for Medical Roll-Over

If you are unable to compete due to injury or illness then you may qualify for a medical transfer to next year’s event. As is clearly stated in our registration materials, there will be absolutely NO REFUNDS.

In order to qualify you must:
• fill this form out completely, and
• attach a note from a health care professional on their letterhead

*NOTE : A processing fee of $25 will be charged for all medical rollovers into next year's event. Please do NOT include personal checks or cash, as this will be done online through the registration website at a later date. Please email registration@caprievents.com if you have any questions about the medical rollover process.

All materials must be postmarked no later than two (2) weeks after the race. All roll-over requests and inquiries will be handled by the Registration Coordinator. All decisions made by the Registration Coordinator are final.

Please mail to:
CAPRI Events - Medical Roll-Over Request
PO Box 577490
Chicago, IL 60657-7490

US Women's
Triathlon Series
(you must check one)

O Naperville - Triathlon
O Federal Way- Triathlon
O San Diego - Triathlon

 

Category
(you must check one)

O Sprint
O SuperSprint

 

Division
(you must check one)

O Individual
O Relay Team
Please Note: Medical roll-overs are non-transferable and valid for ONE year only.


Name:____________________________________________________________

Address:__________________________________________________________

City:____________________________ State:__________ ZIP:______________

Daytime Phone:____________________________________________________

Email:_____________________________________________________________
Please print clearly and provide all of the information requested above.
Incomplete requests will not be considered!