2012 Fun Run - 4th Couch Potato Challenge
ENTRY FORM - read this then scroll down to the entry form itself
Entry Fee
Adults and children 4yrs and older: $10.00 (for either 3.5km or 7km events)
Children 3yrs and younger: FREE
 
Entries Close ...............................  WEDNESDAY 7th MARCH.
 
Payment
If you choose to enter online (use the form below) you may also pay your entry fee directly into the PTFA Bank Account (ASB 12 3008 0012296 00) via your own bank site or via another form of direct payment; please use your family/team name as a reference so we can match payment to your entry and then you need do nothing more. If you complete a paper form (that came home with your child) then please submit that directly to the School Office (not your child’s classroom) with your cheque or cash payment.
 
Fun Run Entry Form
Family/Team Details
*Name :
*Phone number:
*email address:
Entrants:
Children (4 years and over) and Adults [one line per entrant]
*1. Full name:
*1. Run distance:
*1. Age:
*1. Walk/Run:
2. Full name:
2. Run distance:
2. Age:
2. Walk/Run:
3. Full name:
3. Run distance:
3. Age:
3. Walk/Run:
4. Full name:
4. Run distance:
4. Age:
4. Walk/Run:
5. Full name:
5. Run distance:
5. Age:
5. Walk/Run:
6. Full name:
6. Run distance:
6. Age:
6. Walk/Run:
7. Full name:
7. Run distance:
7. Age:
7. Walk/Run:
8. Full name:
8. Run distance:
8. Age:
8. Walk/Run:
9. Full name:
9. Run distance:
9. Age:
9. Walk/Run:
10. Full name:
10. Run distance:
10. Age:
10. Walk/Run:
Cost
*Total number of participants:
*x $10.00 = $:
Declaration/Disclaimer. Neither the organisers, the sponsors nor any party associated with this event shall have any responsibility for any liability, financially or otherwise, which might arise whether or not by negligence, from any direct or indirect loss, injury or death which might be sustained by us or any party directly or indirectly associated with us, from our intended or actual participation in the event and its related activities. Tick the box below to accept these terms and conditions.
Acceptance of Declatation/Disclaimer:

 
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