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Seagrims
PICHI RICHI
2006
Sunday July 2nd 2006
** ENTRIES CLOSE FRIDAY, June 23rd **
Marathon
Half Marathon Half Marathon 10.5 Km
Run Walk
NAME..............................................................………….AGE.................GENDER.................…..............
ADDRESS................................................................................………..............................……………….…
CITY.......................................................………….STATE.......................POSTCODE.............................
PHONE
NUMBER.................................................EMAIL………………………………………………..
T/SHIRT SINGLET SIZE..........................
(T Shirt / Singlet included in MARATHON Fee, but not with Half Marathon /10.5 Km Fee).
REMITTANCE:-
MARATHON:- $35............. Cheques Payable:- Further Enquiries:-
HALF MARATHON / 10.5 Km $15............. Port Augusta YMCA Ring (08) 8641 1703
T/SHIRT $20............. Roadrunners Club. (08) 8641 0045
TOTAL $...................
In consideration of accepting this entry, I the undersigned, intending to be legally bound, hereby for myself, my heirs, and administrators, waive and release all rights and claims for damages or injuries I may have against the Race Director, Pt Augusta YMCA Roadrunners Club, or any or all participating Sponsors as a result of my taking part in the Pichi Richi Marathon, Half Marathon or 10.5 Km event.
I have trained sufficiently to participate in this event and agree to abide by the Race Instructions.
ENTRANTS SIGNATURE............................………………………………
PARENTS SIGNATURE (If under 18yrs)...........................….…………..
Post to:- Pichi Richi Marathon PO Box 388 Port Augusta. 5700
Internet site:- http://www.pichirichi.bizhosting.com