Glen Aggy Trail Run

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Glen Aggy Trail Run

14 September 2019
Registration from 06:00 - 07:00
Starting Times:
21 km - 07:30
10 km - 07:45
5 km - 08:00
Glen Vleis Butchery, R33, Amsterdam, Mpumalanga

First Name *

Last Name *

Gender *

Female

Male

Date of Birth *

YYYY

Email Address: *

Cell Phone Number:

Parents/Guardian details & contact details if participant is under 18

Medical conditions/Allergies *

Emergency Contact Person Details *

Race Category *

5 km Fun Run/Walk - R 30

10 km Run (Participants must be 13 years and older) - R 50

21 km Run (Participants must be 13 years and older) - R 70

All Online Entries must be paid by 13 September 2019 to qualify for standard entry fee. An additional R30 will be added on the day of the race. *

I accept

Required

Banking Details for Online Entries

Bank: Absa
Account Name: KW Munnik
Account Type: Cheque
Account Number: 407 201 6685
Branch Code: 632 005
Reference: Athlete's Name & Trail Run
Proof of payment to: glenaggytrailrun@gmail.com

I, the participant hereby release, hold harmless and forever discharge Grobbelaar Boerdery, Glen Vleis, its share holders, employees or any third party from any claims, demands, actions and causes of action whatsoever arising out of or related to any loss, property damage, personal injury, including death that may be sustained by me or any property belonging to me or that may be caused by myself whilst being at or on any Grobbelaar Boerdery properties. This release and indemnity agreement is binding myself, my heirs, executors, curators, assigns and personal representatives. *

I accept the conditions set by the race organisers

Required

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