TOWNSVILLE RSL AUSTRALIA DAY FUN RUN/WALK 2017

Winner Overall Male$300

Winner Overall Female$300

Winner Junior Male (Under 18yrs)$150

Winner Junior Female (Under 18yrs)$150

Winner Best Dressed Individual $150

Winner Best Dressed Team$150

Please note: If a junior entrant wins an overall prize then they are not eligible for a junior prize

Registrations:6 amFun Run Start:7am

Entry Fee:Gold Coin Donation - All proceeds go toHounds 4 Healing

It is advised that all prams, walkers, strollers and non-competitive entrants start at the back of the race.

(NO BIKES, SKATEBOARDS OR ROLLER-SKATES)

ENTRY FORM

SURNAME ………………………………………… FIRST NAME …………………………...... …..

TEAM NAME (IF APPLICABLE) ………………………………………………………………………………......

(Must be 4 or more in a team)

AGE……… ADDRESS ………………………………………………………… POSTCODE ……………………

Declaration (entries will not be accepted unless signed)

In consideration of my entry, I, my heirs, executors and administrators release and forever discharge the Townsville City Council, their servants, agents and subcontractors, instrumentalities, and all voluntary community groups assisting with this event, all sponsors, producers their agents and representatives of all liabilities, claims, damages or costs which I may have against them arising out of, or in any way connected with my particular event. I understand this waiver includes claims based on negligence, action or inaction of any of the above parties. I fully recognise the difficulties of this event and declare that I am physically fit and able to compete in and complete this event safely, and have not been told otherwise by a medically qualified person. I have carefully read this entry form and agree to abide by all the rules and directions of all event officials on the day of the event.

SIGNATURE OF ENTRANT …………………………………………...... Date: Thursday 26th January 2017

Declaration to be signed by parent or guardian

This declaration must be signed by a parent or legal guardian if you are 17 or under on the day of the race.

I certify that I am the parent/legal guardian of …………………………………………………..…who will be ……...... years of age on the day of the race and that he/she has my consent to run in this event.

Signature ……………………………………………………… Date:Thursday 26th January 2017