In consideration of the acceptance of my entry I, for myself, executors, heirs, administrators and assigns, do hereby release and discharge Mountain Mill Mall, the Breedevallei Municipality and Worcester Gymnasium and all sponsors and voluntary groups, all medical personnel and official helpers from all claims for injuries, damage and property loss I may suffer, caused by negligence of any of them and arriving out of my participation in the event, including pre- and post-race activities. I am physically fit and sufficiently trained to participate in this event and assume all risks for participation. I accept all rules, conditions and regulations, which include terms of payment of the entry fees and will comply with them. I also grant my permission to the Mountain Mill Mall and Worcester Gymnasium to use my name, photographs, video tapes, broadcasts, telecasts, advertising, promotion or other account of this event, free of charge.
By submitting this entry form, I accept the terms and conditions, as set out above.
Closing date for entries
Pre-entries will close at 12 noon on 26 January 2018. Competitors are encouraged to enter online.
On race-day entries will close promptly 40 minutes before each race.
Mile R80 (School teams of five or more pay only R50 per entry)
400m: R40 (School teams of five or more pay only R20 per entry)
Schools may contact firstname.lastname@example.org
Payment and Banking Details
Please ensure that your proof of payment is submitted along with your entry form. Entries without proof of payment will not be accepted.
Proof of payment can be faxed to: 023 3471129 or e-mailed to: email@example.com or firstname.lastname@example.org.
|Account Name||Worcester Gymnasium|
|Reference on slip||"Your name/MMM"