Applications for Ultraman Australia 2018 are now closed.

1. Read the Application Information Guide.
2. Upload a recent photo.  Consider that, if selected, this photo will be used on this website and in our social media profiles.  No hats, sunglasses, pets or other people, please.
3. Answer all questions in the spaces provided.
4. Acknowledge the Waiver, and the Refund and Withdrawals Policy by checking the boxes.
5. Submit the completed application by clicking on the “submit” button at the bottom of the form.
6. The entry fee of AUD$1,995 will be charged to your credit card when your invitation is extended.

Registration Form

Registration Form

If you are human, leave this field blank.

First Name *

Middle Name or Initial

Last Name *

Mailing Address *

City *

State *

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 *

Occupation *

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

Date of Birth (Day/Month/Year) *

Day/Month/Year

Age on May 12, 2018 *

Gender *

Male

Female

Shirt/Jacket Specific Gender Specific *

XS

S

M

L

XL

2XL

Payment Details

Card Type *

Visa

Mastercard

Expiry Date *

Month / Year

Name on card *

Card Number *

Credit Card CCV *

3 Digits on the back of card

Authorisation to charge fees to card *

Yes, i agree to authorise fees to be charged

The entry fee of AUD$1995 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.

Qualifying Event

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 *

Veterans

**List only your most recent Ultraman Distance Race.**

Qualifying Event

Australia

Hawaii

Florida

Canada

Israel

Brazil

Texas

Spain

Mexico

Qualifying Year

Qualifying Time

Unless your latest Ultraman Event or equivalent 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 (10.0 KM – 6.2 Mile Distance)

Swim Time *

2.5 – 3 HRS

3 – 3.5 HRS

3.5 – 4 HRS

4 – 4.5 HRS

4.5 – 5 HRS

5 – 5.5 HRS

OVER 5.5 HRS

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)

Waver and Release Form *

Acknowledgement Waiver & Release from Liability

Read carefully and check. Read Waiver

Refunds and Withdrawls *

Acknowledgement Refunds and Withdrawls

Read carefully and check. Read Policy

Upload Photograph (will be published if you are invited to participate) *

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