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Cool Running NZ Cathay Pacific
Sunday 28 February 2010

General Enquiries:
Sandra Haynes
09.483.2964 or
Alan Moore
09.940.4054

Half Marathon & 11km Run & Walk
Entry Form

Instructions: Print this form, fill it in and mail with payment to:

Calliope A & HC Inc, PO Box 40 053, Glenfield, Auckland. To pay by credit card please use the online entry form.

  • Closing date 12th February 2010. Entries received postmarked before 12th 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

Your details
Surname: ___________________ First Name: ___________________
Address: _________________________________________________
Suburb: _________________________________________________
City: ___________________ Postcode: ___________________
Phone: _________________ (home) _________________ (business)
Email: _________________________________


Event
Please tick one ...
 Half Marathon Run
 Half Marathon Walk
 11km Run
 11km Walk
 
Est. Time: __________ hours _________ minutes


Singlets
Please circle one ...
Female1012141618
MaleSMLXLXXL


Race Packs
I will collect my singlet & event pack from (please tick one)

Langham Hotel Auckland
10am-4pm Thurs 25th & Fri 26th
10am-2pm Sat 27th February
(Late entries accepted here,
cash or cheque only)
Stirling Sports
Westfield Westcity, Henderson
Stirling Sports
Westfield Pakuranga
Stirling Sports
Westfield Manukau
Stirling Sports
Westfield St Lukes
Stirling Sports
Westfield Shore City Takapuna

Packs collected at Stirling Sports stores will be available during store hours from Thur 25th until 2pm on Sat 27th Feb. Uncollected packs will be available on event day from 6:30am at the late entry desk, Orakei Domain.


Remittance
Enclosed is my fee for entry and singlet$45.00
Late entry fee (after 12/02/10) add:$5.00
TOTAL:$_______


Declaration
(To be completed by all entrants)

Neither the organisers, the sponsors nor any party associated with the event shall have any responsibility for any liability, financial or otherwise, which might arise whether or not by negligence, from any direct or indirect loss, injury or death which might be sustained by me or any party directly or indirectly associated with me, from my intended or actual participation in the event and its related activities. In the event of any 'act of god' causing a cancellation of the event, or personal circumstances preventing me from participation my total 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 ...
 Your estimated time
 Event you wish to enter
 Singlet size
 Pickup point

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