Entry Form

Katharine Eustace Fundraising Rogaine

Event Date: Saturday 25 September 2010. Entries close on the day 12.30pm.

 

You can enter online using the form below. No online payment - pay on the day at Registration

Alternatively you can download an Entry Form and pay by Cheque. Click here to download Entry Form

 

Event / Entry Date Team Entry
Minimum 2 people per team		 Family - One or Two Adults
and children up to five per team		 Under 19 - minimum of 2 persons
per team maximum 5 people
6 Hour Event $20 per person n/a $10 per person
3 Hour Event $20 per person $60 per team $10 per person

 

*Price includes post race meal for all competitors.

 

Team Details

Team Name: Required A value is required.   Required

1st Member Name:
A value is required.		    
E-mail: A value is required.Invalid format. Address: A value is required.
Cellphone: A value is required. Town / City: A value is required.

Team Members:		      
2nd Member Name: A value is required. E-mail: A value is required.Invalid format.
3rd Member Name: E-mail:
4th Member Name: E-mail:
5th Member Name: E-mail:

 

Event

6 hr / 3 hr Please select an item.    
     

 

 

Waiver

PLEASE TICK I declare that I have fully read and understand the rules and conditions of the Wanaka Rogaine. I attest that I am fully aware of the risks and hazards involved in participating in this event and I understand that participation in the event is at my/our own risk. In consideration of the acceptance of my entry fee, I do hereby on behalf of my heirs, executors, administrators and assignees release and forever discharge the sponsors, landowners and any and all persons involved in the conduct of the Wanaka Rogaine from any and all liability whatsoever or claims of damages, actions or inaction what so ever (including negligence) in any manner arising out of my participation in the Wanaka Rogaine. I agree that the Highland Events and any sponsor of this event may use information contained in this form for purposes connected with the events associated with Highland Events Ltd., and to provide details of other products, services and events to me from time to time. I understand that I have rights under the Privacy Act 1993 to access and correct any information held about me. All entry fees are non refundable.