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| Half Marathon Entry November 10, 2002 |
| Half Marathon Walk Half Marathon Run Registration Runners: Reg # ______________ Club: __________________________________ |
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| GRADE: (Half Marathon Only) Please tick ONE box only |
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| OPEN MEN M40-44 M45-49 M50-59 M60-69 M70+ |
| OPEN WOMEN W35-39 W40-44 W45-49 W50-59 W60+ |
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| SURNAME FIRST NAME ADDRESS PHONE |
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| 10km FUN EVENT Entry November 10, 2002 |
| INDIVIDUAL |
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| Surname: Address: E-mail: |
| TEAM |
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| Team name or group represented: |
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| RUN |
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| RUN |
| WALK |
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| WALK |
| COMPOSITE |
| Names: 1 3 |
| CONTACT PERSON Surname: Address: |
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| ENTRY FEES (Entries close October 31) Half Marathon $30 ____ 10km Individual $15 ____ 10km Teams $50 ____ Late Entry Add $5 ____ (if dated after October 31, 2002) Tee Shirt (Please tick size below) $30 ____ S M L XL XXL TOTAL _______ Please make cheques payable to HAWKES BAY MARATHON CLINIC and post with entry to PO BOX 537, NAPIER. Have you marked all relevant boxes? Are you entering the Half Marathon or the 10km? Are you running or walking? |
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| DECLARATION - To be completed by all entrants. Entrants under the age of sixteen years require the signature of a Parent of Guardian. I declare that: I/We have read the race information and are aware that road rules apply. I am eligible to compete as an amateur under IAAF rule no. 53. My accepted entry will be transferred to another runner. In the event of any "Act of God" conditions causing a cancellation of the event, my total entry fee is not refundable. Neither the organisers, the sponsors nor other parties associated with the event shall have responsibility for any liability, financial or otherwise, which might arise whether or not by negligence, from any direct or indirect loss, injury or death which might be sustained by me or any other party directly or indirectly associated with me, from my intended or actual participation in the event or its related activities. I authorise my name, voice or picture and any information on this entry form to be used without payment to me in any broadcast, telecast, promotion, advertising, or in any other way relating to this event puruant ot the Privacy Act 1993. Signed __________________________________Date __________ Signed __________________________________Date __________ Signed __________________________________Date __________ Signed __________________________________Date __________ |
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| www.oocities.org/napierhalf |
| First Name: |
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| 2 4 |
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| First Name: E-Mail: |
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| You will need Adobe Acrobat to open this file. If you co not have Adobe Acrobat, a free 'reader' can be downloaded from www.adobe.com Click on the symbol above to go to the site. |
| PLEASE NOTE - This is not an on-line entry form. You will need to print this form, fill it in, and send it with your payment to Hawkes Bay Marathon Clinic PO Box 537, Napier. |