Entry Fees:
Adult: $20.00 (includes T-Shirt or Tank)
$10.00 (no T-Shirt or Tank)
Children: $15.00 (includes T-Shirt or Tank) $5.00 (no
T-Shirt or Tank)
Families: $50.00 (includes 5 T-Shirt or Tank - $10.00
each additional T-Shirt)
Corporate: $150.00 (includes 10 T-Shirt or Tank - $10.00
each additional T-Shirt)
Registration:
Entry forms
can be picked up at Front Runners (1200 Vancouver Street) or Esquimalt
Recreation Centre (527 Fraser St).
Please mail
completed entry forms to: 1010 Lyall Street, Victoria BC, V9A 5E9 OR
Drop off at
Frontrunners or the Esquimalt Recreation Centre until Saturday March 29
T-Shirts can
be picked up on Saturday March 29 from 10am - 2pm @ Esquimalt Recreation Centre
-------------------------------------------------------Entry Form--------------------------------------------------------------
Name:__________________________________________________________________________________
(Surname) (Given
Name) (Initial)
Address:________________________________________________________________________________
Telephone number: ____________ Date of Birth: _____________ M/F
________________
IMPORTANT: Information for additional entrants
must be included to ensure accurate race number registration
Waiver: Upon acceptance of this entry, I hereby
for myself, my heirs, executors, waive and release the organizers of this event
and its sponsors any and all rights or claims for damages I may have against
them, their representatives, successors and assigns, for any and all illness, injuries
and/or losses I may sustain as a result of my participation in this event.
Signed: _________________________________________
(under 19’s must be signed by parent or guardian, unsigned registrations will
not be accepted)
Date:
___________________________________________
Method of Payment:
Cheque
(payable to the "Keep the Hope Alive Drive”)________ (Amount paid)
Cash ______(Amount
paid)
__ Adult __ Child __ Family (Make
sure to submit all names and ages of additional family
members)
__ Corporate (Make sure to submit names and
ages of all participants)
T-Shirt size: __
Youth __ Medium __ Large __XLarge ____ XXLarge Tank sizes:
___Small ___ Medium __ Large
I WANT TO VOLUNTEER:
_____ Road
Marshall ___ Race Day Registration