Sri Chinmoy Half-Marathon 5-10km Mid-Year Series 2012

8.00 am Sundays: • 01 April • 13 May • 10 June • 15 July • 05 August • 09 September 2012
Auckland Domain Cricket Pavilion – off Carlton Gore Road. Pick up race numbers on the day after 7.00 a.m.

This form is for online entry with payment by credit card/debit card (Visa or Mastercard).
Online entries are processed by Cool Running New Zealand - Security & privacy information is here.
For print & post entry use the print & post form (201kb PDF).

Online entry will be accepted up to midnight the Friday before each event.

Early Bird/ Series Discounts … Pre-enter 2-6 races (one person/ multi-dates only) and save!
Select Events Entered: 21.1km (run/race-walk only - 2.30 time limit)
[17 years & over]		 10km (run/walk)
[15 years & over]		 5km (run/walk)
[13 years & over]
Race 1 • Sun 01 April 12 21.1km 10km 5km
Race 2 • Sun 13 May 12 21.1km 10km 5km
Race 3 • Sun 10 June 12 21.1km 10km 5km
Race 4 • Sun 15 July 12 21.1km 10km 5km
Race 5 • Sun 05 Aug 12 21.1km 10km 5km
Race 6 • Sun 09 Sep 12 21.1km 10km 5km

ADULTS
No. of Events Entered/ Amount Payable		 YOUTHS 13-19
No. of Events Entered/ Amount Payable
1 $27 1 $22
2 $45 2 $40
3 $50 3 $45
4 $75 4 $65
5 $90 5 $85
6 $95 6 $90

First Name:
Surname:
Age on event day:
Age grade:Adult     Youth 13-19
Gender:Male     Female
Address:
Phone (day):
Phone (evening):
Email address:

Waiver

In consideration of the acceptance of my entry, I do hereby, for myself, my executors and assignees, release and forever discharge the organisers and their respective officers, agents, representatives and/or assignees and supporters from all claims of damages, demands, actions which I or they might have for and arising out of loss of my life, injury, damage or loss of any description whatsoever in any manner arising out of my participation in this event.
I attest and verify that I have full knowledge of the risks involved in participating and that I have no physical or mental condition which has the potential to put myself or any other person at risk and that I am physically fit and sufficiently trained to participate in this event.
I hereby consent to receive any medical treatment that may be deemed advisable by the organiser during the event and I agree to pay for medical treatment, including transport by ambulance, which is provided to me at the request or direction of the organiser before, during or after the event.
I have read and understood the health and safety conditions listed on the event website and agree to abide by them and to accept any decisions made under them. I am aware that I will be required to sign a waiver before commencing the race on the day of the event, and that failure to do so will result in my immediate disqualification from the event.
I agree to have my photographic image used in future event publications and websites by the event organizer.

I agree - Name: Date:

Send Details

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Page created by Cool Running New Zealand updated 25 October 2011