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2019 Shepherds' Shemozzle - Registrations
SHEPHERDS’ SHEMOZZLE™ in association with BLACK HAWK
START TIME 3pm Saturday 2nd November 2019

Major prizes, plus various spot prizes
All shepherds who attend the Shepherds’ Shemozzle receive a t-shirt

ENTRY FEE: $30.00 Early Bird
$40.00 Registration on the day


CONDITIONS
• No person is permitted to run in support of a contestant or in place of a contestant.
• Organisers reserve the right to eliminate a runner at any stage should safety be compromised or rules broken.
• Organisers also reserve the right to alter the programme as they see fit.

First Name *
Your answer
Last Name *
Your answer
Dog's Name *
Dog must be a huntaway that barks on command, and must not be on heat.
Your answer
Address *
Your answer
Category *
Date of Birth *
Your answer
Age on Race Day *
Your answer
If aged under 16 years of age on race day...I, below named parent of this race participant, give permission for my child to run in the Shepherds Shemozzle race.
Your answer
Station Name for Station Challenge (where you work)
Your answer
Shirt Size *
Food - This race has a food station with randomly selected food item(s). If you have food allergies please consider this before entering. Competitors who do not consume the food item at this station may complete the race but will be disqualified - no exceptions. Ticking Yes means you accept this condition. *
Required
I have paid via internet banking to account number : 02-0684-0006453-00 using Reference: (Full Name) and Code: (SHPHRD) *
Required
Email Address *
Your answer
Contact Phone Number *
Your answer
I absolve the Hunterville Huntaway Festival Committee of any liability should injury or death happen to either myself and / or my dog during the running of the Hunterville Shepherds Shemozzle and I agree to keep the Committee both collectively and individually indemnified, safe and harmless from any claims, costs, damages or liabilities that may arise against them out of my participation and that of my dog in the said event. It has been made clear to me that roads have been closed to stage the event and that every endeavour has taken place to remove all known hazards on the course and about the obstacles involved. I am aware that the Shemozzle is a high risk event and that I take full ownership of any injury or death to either myself or my dog during the race. I also acknowledge that no third party will attempt to hold the Hunterville Huntaway Festival Committee liable for injury or death to myself or my dog and that I will not lend any assistance to any third party wishing to pursue a claim in the consequence of injury or death to myself or my dog. Please note: By entering this event, unless otherwise advised, I also agree that the Hunterville Huntaway Festival Committee may use this information or disclose it to other organisations that may use it, in any media for future promotional, marketing & publicity purposes without any further reference, or compensation to the entrant. *
Required
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