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Sunday 27 February 2011 |
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race info
online entry
print entry form
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sponsors
email
General Enquiries:
Sandra Haynes
09.483.2964 or
Alan Moore
09.940.4054
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Half Marathon & 11km Run & Walk
Instructions: Print this form, fill it in and mail with payment to:
Calliope A & HC Inc, PO Box 40 053, Glenfield, North Shore City 0747. To pay by credit card please use the online entry form.
- Closing date 11th February 2011. Entries received postmarked before 11th February will be in the draw
for a postal entry prize.
- Make cheques payable to: Calliope A & HC Inc. You may also pay by direct credit to our bank account -
ASB Birkenhead AC 123-011 0801739 01. (Please attach confirmation of payment).
- All entrants must sign the declaration
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Your details
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| Surname: |
___________________ |
First Name: |
___________________ |
| Address: |
_________________________________________________ |
| Suburb: |
_________________________________________________ |
| City: |
___________________ |
Postcode: |
___________________ |
| Phone: |
_________________ (home) _________________ (business) |
| Email: |
_________________________________ |
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Event
Please tick one ...
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 Half Marathon Run
Half Marathon Walk
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11km Run
11km Walk
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| Est. Time: |
__________ hours _________ minutes |
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Singlets
Please circle one ...
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| Female | 10 | 12 | 14 | 16 | 18 |
| Male | S | M | L | XL | XXL |
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Race Packs
I will collect my singlet & event pack from (please tick one)
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Langham Hotel Auckland
10am-4pm Fri 25th
10am-2pm Sat 26th February
(Late entries accepted here,
cash or cheque only)
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Stirling Sports
Westfield Westcity, Henderson
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Stirling Sports
Westfield Pakuranga
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Stirling Sports
Westfield Manukau
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Stirling Sports
Westfield St Lukes
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Stirling Sports
Westfield Shore City Takapuna
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Packs collected at Stirling Sports stores will be available during store hours from Fri 25th until 2pm on Sat 26th Feb. Uncollected packs will be available on event day from 6:30am at the late entry desk, Orakei Domain.
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Remittance
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| Enclosed is my fee for entry and singlet | $45.00 |
| Late entry fee (after 11/02/11) add: | $5.00 |
| TOTAL: | $_______ |
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Declaration
(To be completed by all entrants)
I declare that:
- I hereby release the event organisers, the event sponsors and any other party associated with the event of any liability of any kind whatsoever (including liability for negligence) which might arise from any direct or indirect loss, injury or death which might be sustained in connection with my actual or intended participation in the event and its related activities.
- Should the event be cancelled or stopped for any reason, or should personal circumstances arise that prevent me from participating in the event or completing the event, I accept that my total entry fee is non-refundable.
Signed:_____________________Date:_________
The personal details of all entrants will remain confidential but may be used by the sponsors for promotional purposes only.
Please tick box if you do not wish to be contacted in future regarding
special promotions.
Checklist
Have you indicated ...
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Your estimated time
Event you wish to enter
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Singlet size
Pickup point
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