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Wild Goose Chase Entry Form


Mail deadline: May 26, 2000
We will accept registration morning of race (9:00-9:45am)
Cheques payable to 'Wild Goose Chase'
Mail to:
Wild Goose Chase
PO Box 2766
Vanderhoof, BC
V0J 3A0
Ensure the following: Questions? call Brian, Race Director, at 567-5324 (evenings) or 567-5133 (daytime)

cut out and mail

Name of Runner:________________________________ Phone:______________________

Address:______________________________________ Postal Code:__________________

Check one only: _____male _____female                             Age as of December 31/99______

Are you a member of the BC Athletics? _____yes _____no

Category: (circle one only)  4km  or  8km

Waiver: In consideration of the organizers accepting this entry, I hereby myself my heirs, executors and administrator, WAIVE and RELEASE any and all right and claim for any damages of any sort I may have against the organizers of the Wild Goose Chase, their agents, representatives, successors and assigns, for any injuries suffered by me at this race, or damages sustained by me as a result of this race for any cause whatsoever, including negligence.  It is EXPRESSLY UNDERSTOOD by the undersigned that this race is entered into at the sole risk of the undersigned and that all organizers of the race are exempt from liability for any and all damages sustained and any and all injury and loss including personal and property loss arising from any cause whatsoever including negligence.  (Competitors under the age of 19 must have the signature of a parent or legal guardian).
 

 __________________________                                      ________________________________________
 Athlete's Signature                                            Parent of Guardian (if under 19)