If you are human, leave this field blank.
First Name *
Middle Name or Initial
Last Name *
Mailing Address *
Postal Code *
Country Australia Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Aruba Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Cote d’Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor (see Timor-Leste) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles New Zealand Nicaragua Niger Nigeria North Korea Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe
Email Address *
Phone Number *
Mobile/Cell Phone *
Which country are you representing *
Social Media Identifiers (@twitter, #instagram, Facebook etc – to share your results and progress if invited to participate)
Triathlon Australia (or Affiliate) Membership Number (Non-members will be charged an extra AUD 25.00 at the time of registration to cover Triathlon Australia event membership).
If Affiliate, name of organisation
Age on May 9, 2020 *
Jacket Size, Gender Specific *
Women’s sizes translate to Australian 8 = XS, 10 = S, 12 = M, 14 = L, 16 = XL, 18 = 2XL
Card Type *
AMEX not accepted.
Name on card *
Card Number *
Authorisation to charge fees to card *
The entry fee of AUD$2100 will be charged to your credit card when your invitation is extended. Triathlon Australia Event Membership Fee (AUD$25.00) will be charged if TA or Affiliate non-member.
List one (1) Iron Distance or longer race completed during the previous 18 months. It is required that your finishing time be under 14 hours 30 minutes for the Iron Distance.
Race Name *
Race Date *
Finishing Time *
Result link to this event *
**List only your
most recent Ultraman Distance Race.**
Unless your latest Ultraman distane event has been within the last two years, you will need to have a qualifying Iron Distance race in the previous 18 months. List your result above under the Qualifying Event.
Estimate Swim Time
Select your estimated swim time (10km Open Water)
Additional Information or Race Results for All Applicants
Why are you entering Ultraman Australia? (50 words, will be published if you are invited to participate)
Upload Photograph (will be published if you are invited to participate) *
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