Mauku Fun Run Entry Form 2020

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Welcome to your entry form for the Mauku Fun Run on Sunday 29th March 2020.
Please remember this is a FUN RUN - please take care of yourself and others on the course.
Marshals will be on the course and the road will remain open at all times to vehicle traffic.
NO DOGS or BIKES on course.

Please fill in this form for each person entering OR
FAMILY ENTRY - tick option for family, enter contact name and scroll down to option box for entry of family members
TEAM ENTRY - tick option for team, enter team leader contact details and scroll down to use option box for entry of team members

PAYMENT via internet banking: Mauku Fun Run: ASB 12 3023 0375116 01 Please use your name as reference

Email *

Event *

Please choose your event. Please enter the RUN if you are going to run any part of the event.

5km RUN (single entry)

5km WALK (single entry)

10km RUN (single entry)

10km WALK (single entry)

TEAM (add distance in another box)

FAMILY (add distance in another box)

First name *

Surname *

Phone (mobile) *

Phone (home)

Date of birth *

YYYY

ENTRY FEES (all proceeds to Mauku School) *

Child (under 12yrs) all events $10.00

Adult (12yrs and over) 5km $20.00

Adult (12yrs and over) 10km $25.00

Family Rate $ 50.00 (2 adults and up to 4 children)

Team Rate $200.00 (per team of 10 - adults or children - 5km or 10km)

FAMILY NAME (Family entry details)

FAMILY DETAILS (2 adults and up to 4 children)

eg. Joe Bloggs (5km walk), Mary Bloggs (10km run)

TEAM NAME

TEAM MEMBER DETAILS (team of 10, adults or children 5km or 10km

eg. Joe Bloggs (5km walk, Mary Bloggs (10km run)

Payment Information

Internet Banking 12 3023 0375116 01 (ASB - Mauku School BOT).
Postal entries close TUESDAY 24TH MARCH 2020

LATE ENTRY FEE...LATE ENTRY FEE....LATE ENTRY FEE
Applies from TUESDAY 24TH MARCH 2020
Child entry fee remains $10.00 (under 12yrs)
5km $25.00
10km $30.00
Family $60.00
Team $220.00

DECLARATION
THIS IS A FUN RUN - PLEASE HAVE FUN AND TAKE CARE OF EACH OTHER.
ROADS ARE NOT CLOSED DURING THE EVENT. Traffic will be managed by Pro-Tect Traffic Management and marshalls on course.
A safety briefing will be held before the start of each event, all competitors are required to attend.
Neither the organisers, the sponsors nor any party associated with the event shall have any responsibility for any liability, financially or otherwise, which might arise whether or not by negligence, from any direct or indirect loss, injury or death which might be sustained by me or any party directly or indirectly associated with me, from my intended or actual participation in the event and its related activities.
In the event of any "act of god' causing a cancellation of the event, or personal circumstances preventing me from participation my total fee is non-refundable. Children are the responsibility of their parents.
The entrant agrees that their name, voice and/or picture obtained at the event, can be used without payment in any media, advertisement, promotion or in any other way related to this event.

RACE ORGANISER: Mauku School. Contact: Leanne McMurtrie (09) 236 3654
EMAIL: maukufunrun@gmail.com
RACE HEADQUARTERS: Mauku School, 389 Union Road, Mauku.

Declaration *

I agree that I have read the Terms and Conditions of entry to the Mauku Fun Run 2020 event.

Yes

Required

A copy of your responses will be emailed to the address you provided.

Submit

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