2018 Mouth 2 Mouth Run Entry
Thank you for registering for the 2018 Mouth2Mouth Run.

1. Online entries will be accepted up until 5pm Friday 12th January. Entries after this time will be $10 additional for the 7km & 14km's and $5 additional for the 3km.

2. Complete the form and deposit the registration fee in the Mouth2Mouth account using your name as the reference.
BSB: 633 000 Account Number: 147 078 588

3. Any questions? Contact Dion on 0404 800 073

Sunday 14th January 2018
Last Name
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First Name
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Date of Birth
Ensure you change the year to your year of birth.
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Email
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Phone Number
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Address
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Event
Disclaimer Acknowledgement
I acknowledge that running events involve the real risk of serious injury or even death from various causes including over exertion, on and off course accidents, equipment failure, other road users, spectators, course conditions, weather conditions and/or unforeseen circumstances. I understand that I should not compete in this event unless I have trained the necessary amount and my medical practitioner has verified my physical condition. It is my sole responsibility to ensure such training and medial verification. By entering this event and competing, I accept all risks associated from my participation that could result in loss of life or permanent injury. Accordingly I release all people associated with the conduct of this event from and waive all claims what so ever, and will indemnify them against all liability (including liability for their negligence) for all injury, loss and damage arising out of or connected with my participation in this event. I consent to receive any medical treatment the event medical team and/or event organiser believes appropriate in the circumstances before, during or after the event. I understand that safety precautions undertaken at the event are merely a service to me but are not a guarantee of safety.
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