Run_The_Kingdom_Event_Entry_Form_2015
Transcription
Run_The_Kingdom_Event_Entry_Form_2015
MAIL ENTRY FORM AND MAKE BANK CHEQUE/POSTAL ORDER PAYABLE TO: RUN THE KINGDOM, 17 Pier Village, Tralee, Co. Kerry, Ireland. Postal registration form & cheque must be received at the Run The Kingdom office at least 7 working days before the event date to ensure your inclusion. Registered Business Number: 507828 Telephone: 00 353 (0) 87 928 26 83 Email: info[at]runthekingdom.ie (Please tick the RED box for the event/s you would like to register for) [__] Kerryhead Half Marathon & 10K Run Saturday 13th June 2015 Registration Fee: €40.00 Half Marathon / €20.00 10K Run [__]The Blennerville 10K & 5K Road Race Sunday 28th June 2015 Registration Fee: – 10K- €20.00 – Under 18 €10.00 (under 18 can enter at Blennerville N.S) – 5K- €10.00 – Under 18 €5.00 [__] Tralee Summer Solstice 10k Sunday 21st June 2015 Registration Fee: €20.00 [__] Camp Trail Summer Running Festival Sunday 28th June 2015 Registration Fee:€30.00 [__] Valentia Island Cable HalfMarathon & 10K Saturday 10th October 2015 Registration Fee: €35.00 Half Marathon / €20.00 10K First Name(s): _____________________________ Last Name: ______________________________ GENDER: Female: _____ / Male: _____ / Date of Birth: _____ /_____ / _____ Email Address:_____________________________ Mobile No.: __________________________ Other Phone No.: ______________________________ T-SHIRT SIZE: S: _____ / M: _____ / L: _____ / XL: _____ / PLEASE ENTER YOUR FULL ADDRESS - Where Run The Kingdom sends any information by post, this is the address used. Address 1: ______________________________________________________________________ Address 2: ______________________________________________________________________ Town: ___________________________________ County: ________________________________ Are you taking part in the Kerry Marathon Championship Yes: _____ / No: _____ / Club: ___________________________________________________________________________ IN CASE OF AN EMERGENCY CONTACT DETAILS: Name: ____________________________________ Contact Number: _______________________ WAIVER: I know that running a road race is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I assume all risks associated with running this event. Having read this waiver and knowing these facts and in consideration of your accepting my entry fee, I, for myself, and anyone entitled to act on my behalf, waive and release the town of Tralee, Run The Kingdom,, and all sponsors, their representatives and successors, for all claims or liabilities of any kind arising out of my participation in any Run The Kingdom event. Once entry is confirmed by e-mail we cannot refund or exchange numbers. __________________________________________ _____________________________________ Signature Date