White Clay Trail Run 2018
Entry Form | White Clay Trail Run | 25 AUGUST 2018
Name and Surname:
Your answer
ID Number:
Your answer
Contact number:
Your answer
Email address:
Your answer
Male / Female:
Medical AID and Medical AID Number:
Your answer
Emergency Contact Person:
Your answer
Emergency Contact Number:
Your answer
Runner / Walker:
ENTRY FEES:
21km Trail Run/Walk: R200.00 per entry
Event t-shirt to the first 150 entries. Medal to all finishes.
PAYMENT DETAILS:
Payment via EFT
Account details:
Craig Muller Media
Standard Bank - Branch: Vincent Park - Branch Code: 05 37 21
Account number: 33 175 6315
Reference: WC - Name & Surname
Email completed form and proof of payment to: escape@backyard-adventures.co.za
INDEMNITY
I am aware of the risks and potential hazards involved in an event of this nature and will participate completely at my own risk. I will adhere to the rules and regulations of the event and the safety measures the organisers deem to be necessary. I understand that neither the organisers of the event, the sponsors, nor the land owners, can be held liable for any personal injury or loss I might sustain while participating in the White Clay Trail Run.
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