(Please Print) |
Event (please tick)  |
First Name: __________________________________________________________
Surname: __________________________________________________________
Address: __________________________________________________________
Suburb: _______________________________________ Postcode __________
City: __________________________________________________________
Email: __________________________________________________________
Phone: __________________________________________________________ |
 ½ Marathon Run
½ Marathon Walk
10km Run
10km Walk
|
Male Female
Date of Birth: ______________ Age at race day: __________ |
| |
Grade (Half Marathon entries only) |
Declaration (To be completed by ALL entrants. Entrants under the age of 16 yrs require parent or guardian signature.)
I declare that: I/We have read the race information and are aware that road rules apply at all times and there are no road closures. I am eligible to compete as an amateur under IAAF rule no. 53. My accepted entry will not be transferred to another runner/walker. In the event of an “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 results, broadcast, telecast and/or promotion pursuant to the Privacy Act 1993.
Signature: ____________________________
Date: __________________ |
Open Men
Men 35 – 39
Men 40 – 44
Men 45 – 49
Men 50 – 59
Men 60 – 69
Men 70+ |
Open Women
Women 35 – 39
Women 40 – 44
Women 45 – 49
Women 50 – 59
Women 60 – 69
Women 70+ |
|
| Quality Commemorative Shirt $35.00 |
| Female fit sizes |
8 |
10 |
12 |
14 |
16 |
18 |
20 |
| Male fit sizes |
S |
M |
L |
XL |
2X |
3X |
5X |
|
Entry Fee half marathon ($ 35.00): $
|
Entry Fee 10km ($ 15.00): $ |
|
Admin fee for registration after
11 April 2010 ($ 10.00) $ |
Shirts at $35.00 each $
Order no later than 7 April! |
Payment Enclosed $
Make cheques payable to Run Walk Hawke's Bay and send form to Hastings Half Marathon, 707 Gordon Rd, Hastings 4120 |
Have you ticked your event?
Have you ticked your grade (full marathon only)?
Have you circled your T-shirt Size (optional)?
Have you signed the declaration?
Have you made out your cheque to Run Walk Hawke's Bay? |
