Entry Form
2007 Cannery Road Race
Please enclose cheque or money order payable to:
Rupert
Runners
P.O. Box 22093, RPO Downtown
Prince Rupert, BC, V8J 4P8
Please Print
Name:_______________________________________________________________________________
Address:______________________________________________________________________________
City, Province, Postal Code:____________________________________________________________
Phone Number:__________________________E-mail:_______________________________________
___21.1k Run ___10k Run ___10k Walk ___5k Run ___5k Walk ___Kids 1k
___Male ___Female Age on Race Day: ______
Unisex T-Shirts Size: ___Adult ___Kids (fun run only) ___ S ___M ___L ___XL
Race fee: $30.00 (15 and under race fee is $15.00)
Kids fun run is FREE
(BC Athletics Athlete Members receive $3.00 discount)
BC Athletics Membership# ___________________
Amount enclosed: _______________
Waiver: In consideration of your accepting this entry, I, the undersigned, intending to be legally bound, hereby, for myself, my family, my heirs, executors and administrators, forever waive release and discharge any and all rights and claims for damages and causes of suit of action, that I have or may at any time have against the Cannery Road Race committee, officials, and volunteers and all sponsors of the Cannery Road Race Event, for any and all injuries or losses suffered by me as a result of my participation in this event. I attest that I am physically fit, am aware of the dangers and precautions that must be taken when running or competing, and have sufficiently trained for the completion of this event.
Signature (Parent if under 19): ________________________________________
SORRY NO REFUNDS
Cannery Road Race Logo and T-shirts are designed by Nicole Narbonne. To see more of Nicole's work visit: www.skeenastreetstudio.ca