Hosted by Raymond Terrace Athletics Centre

Sunday May 19th, 2013

Hosted by Raymond Terrace Athletics Centre

Located at WallarooStateForest,10 km north of Raymond Terrace,

Turn off the Pacific Highway at Nine Mile Creek Rd

The 3 runs follow fire trails through a tranquil forest setting

The 10 km run begins at 10.30 a.m.

The 6 km run begins at 12.00 p.m.

The 2 km run begins at 1.30 p.m.

Entry fee - $15 per adult, $10 for 16 yrs & under, $40 per family,$5 per additional run

Free Wallaroo State Forest Fun Runsun visor for the first 50 entries received by Fri10th May.

Entries on the day will be accepted up to 30 minutes before each run.

Trophies, medals & certificates are awarded after each run.

PROUDLY SPONSORED BY:

Forestry Corporation of N.S.W.

Active 4 Life Physiotherapy

Direct deposit to NewcastlePerm BSB: 650 000 / Acc: 965308626 / Name: Raymond Terrace Athletics Centre, please enter your name as the description or write a cheque made payable to RTAC.

Entries areto be sent with either the cheque or direct deposit receipt to:

WallarooStateForest Fun Run, PO Box 91, Raymond Terrace, 2324

For further details, contact Deidre on 0418 962 185

WALLAROOSTATEFOREST FUN RUN ENTRY FORM

NAME ______DOB______AGE ON DAY______

ADDRESS ______SEX M / F

EMAIL ADDRESS FOR NEXT YEAR’S ENTRY FORM ______

10 KM RUN:( ) Under 16 ( ) 16-19 ( ) 20-30 ( ) 31-40 ( ) 41-50 ( ) Over 50

6KM RUN:( ) Under 11 ( ) 11-12 ( ) 13-15 ( ) 16-20 ( ) 21-30 ( ) 31-40 ( ) 41-50 ( ) Over 50

2KM RUN:( ) Under 7 ( ) 7-8 ( ) 9-10 ( ) 11-12 ( ) Open

TEAMS: ( ) Parent & U13 child (max 2) ( ) School students (max 4)

RULES & CONDITIONS

Each competitor will run the approved course as directed, will not accept outside assistance & will accept the judges decision as final. Only 1 individual award may be won by any runner with the exception of team events. Once receiving a trophy for any event, you will not be eligible for the individual category medal. Each member of the School Team Category must be a student from the same school. It is up to the competitors to ensure that their time and place are recorded correctly.

DECLARATION

I, the undersigned, in consideration of, and as a condition of acceptance of my entry in the Wallaroo State Forest Fun Run, a community fitness fun run for myself, my heirs, executors and administrators, hereby waive all and any claim, right or cause of action which I or they might otherwise have for, or arising out of, loss of any description whatsoever which I may suffer or sustain in the course of or consequent upon my entry or participation in the said event. This waiver release and discharge shall be and operate separately in favour of all persons, corporations and bodies involved or otherwise engaged in promoting or staging the event and the servants, agents, representatives and officers of any of them. I declare that I take part in sport only as an amateur and NOT for any monetary consideration. I will abide by the competition rules. Amateur status is defined by the IAAF as “one who competes for the love of the sport and as a means of recreation without the motive of securing any material gain from such competition.”

SIGNED (entrant) ______

If you are 16 or under, this form must be signed by your Parent/Guardian.

SIGNATURE OF PARENT / GUARDIAN ______