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