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This form is for print & post entry, with payment by cheque. Online entry will be available at the Hamilton City Hawks web site www.Hamiltoncityhawks.co.nz from 12th February 2010.
Instructions: Print this form, fill it in and mail with payment to:
Huntly Half Marathon, PO Box 9465, Hamilton
- Please makes cheques payable to Hamilton City Hawks
- Closing date Thursday May 13th 2010 - Late entries pay Late Fee
- PLEASE USE BLOCK LETTERS
- All entrants must sign the declaration
special offer!
Join the Hamilton City Hawks and run this year's Huntly Half Marathon for FREE - conditions apply.
Check our website: www.hamiltoncityhawks.co.nz
Contact:
your details
| First Name: |
_________________________________ |
| Surname: |
_________________________________ |
| Postal Address: |
_________________________________ |
| Suburb: |
_________________________________ |
| City: |
_________________________________ |
| Postcode: |
_________________________________ |
| Phone: | ________________ | Email: | _______________________ |
| Cellphone: | ________________ | |
| Date of Birth (dd/mm/yyyy): | ________________ | Age on Race Day: | _____ |
Club:
(if applicable) |
_________________________________ |
| | Athletics NZ Registered Runner: | _____ (Y / N) |
event
Event:
Tick one box only
 | Half Marathon Run |
| Mizuno 10km |
| Half Marathon Walk |
| NB Entrants intending to Walk/Run must enter the Run |
| NZ Half Marathon Championship (Must be ANZ registered) - Half Marathon Run entrants only |
| ____________ ANZ Registration Number |
Grade:
Tick one box only
| 1. Men Open |
| 9. Women Open |
| 2. Vet Men 40-44 |
| 10. Vet Women 40-44 |
| 3. Vet Men 45-49 |
| 11. Vet Women 45-49 |
| 4. Vet Men 50-54 |
| 12. Vet Women 50-54 |
| 5. Vet Men 55-59 |
| 13. Vet Women 55-59 |
| 6. Vet Men 60-64 |
| 14. Vet Women 60+ |
| 7. Vet Men 65+ |
| 15. Women Under 20 |
| 8. Men Under 20 |
| |
remittance
| $45 | Half Marathon Run | $_____ |
| $45 | Half Marathon Walk | $_____ NB Walk/Runners must enter the Run |
| $25 | 10km FunRun/Walk | $_____ |
| $10 | Late Entry Fee (after 13/5/10) | $_____ |
| $35 | Mizuno Performance Tee (RRP $70) | $_____ |
| size S / M / L / XL / 8 / 10 / 12 / 14 / 16 |
| $5 | Hawks Members Discount | $_____ |
| | TOTAL REMITTANCE | $_____ |
declaration
I declare that I am an amateur as defined by the IAAF rules under rule 53.
I enter and intend running entirely at my own risk.
Approved by Athletics Waikato and conducted under Athletics New Zealand rules.
Signed:________________________
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