A LIONS CLUB OF FOXTON PROJECT
Foxton Beach Fun Run
Sunday 15th March 2020
Entry Form
Waiver:
I accept the conditions of entry, while recognising and agreeing that beach/road running and walking may be a risky and physically challenging undertaking. I acknowledge that vehicular traffic has access to the beach where this event is taking place, and enter this event knowing full well the risks and demands involved and undertake to follow all event rules and instructions. I understand that while the organisers have arranged some road closures and controlled road crossing that they cannot be held responsible for the actions of members of the public. Therefore I/we take personal responsibility for my/our fitness, experience and actions during this event. If I am entering this event as a wheelchair athlete, I accept full responsibility for the roadworthiness of any/all equipment I am using. As such, I, my family, heirs and executors of any estate discharge the event organiser, sponsors and all other persons involved in the event of any liability, claims or damages relating to personal injury, loss or damage of equipment, or any matter arising from the event. I enter knowing that entry fees are strictly non-refundable. I acknowledge that organisers reserve the right to change the course or cancel the event due to act of god or other circumstances beyond the organisers control, without any refund. I authorise my personal details, voice and picture to be used without payment in any capacity relating to the event. I understand that if I am under age 16 that this entry must be filled out and signed by my parent or guardian. You Can Scan and send to funrun@foxtonlions.co.nz and pay online A/c No: 03-0633-0018905-00 Foxton Lions Club.Signature (Parent if under 16)
...........................................................................
Date ......../......../............
| Event | Half Marathon $30 | 10Km $20 | 5Km $10 | 5Km Primary School $5 |
| Please put a tick in the desired distance |
| Name: | |
| Address: | |
| Age on day of event if under 17: | |
| Male: | |
| Female: | |
| Telephone (Day): | |
| Email Address |
Please advise: |
Amount Paid $.................... |
| Date of Payment ......../......../............ |
| Name of Payer ................................... |
| Race Numbers are to be picked up on 15th March 2020 from 7:00 a.m |