#ResolutionRun19 Entry Form
Please complete this form in full to ensure accurate data capturing and results
Email address *
Name & Surname *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
ID Number *
Your answer
Country of Residence *
Cellphone Number *
Your answer
Full Medical Aid Details *
Your answer
Emergency Contact *
Your answer
Please Choose Appropriate box
5km (E 80.00)
10km (E 120.00)
21km (E 150.00)
Cubs and Guardians <12
Sub Junior (13-14)
Youth (15-16)
Junior (17-18)
Senior (19-29)
Sub Veteran (30-39)
Veteran (40-49)
Master (50-59)
Grand Master (60+)
T-shirt Size *
Momentum Health Client
If "Yes", Please Provide Medical Aid Details
Your answer
Payment details: BGP Projects 020000244067 Nedbank Mbabane 360164 (Please use Reference Number or Surname as Reference) Proof of Payment to be emailed to resolutionrun@biggameparks.org to confirm entry
Your answer
Momentum Short Term Client
If "Yes", Please Provide Policy Details
Your answer
Waiver & Indemnity: I hereby declare that I am 18 years or older or that I am the parent/legal guardian of the aforementioned minor, I also declare on behalf of myself/minor in my charge that I: Assume all risk of participation in the BGP Resolution Run, Absolve and discharge the organisers, officials, marshalls, helpers, sponsors or any local authority or employee of the aforementioned parties from all claims for loss, damage, injury or death, howsoever caused, arising from participation in the BGP Resolution Run, Agree to abide by all rules and regulations of the race and Hlane Royal National Park. *
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