entry form

Which event are you entering?

Personal Details:

Surname or Family Name:__________________________________
                            
Given Name:                 ___________________________________		Date of Birth:_________________

Anticipated Time:          ___________________________________ 		Age on Race Day:____________

Mailing Address: 	(number and street) __________________________________________    

				(suburb & town) _____________________________________________

				(country & postcode)_________________________________________

day telephone:______________________	after hours telephone:______________________

Merchandise:
Please tick your order and add the costs onto your payment details. Your merchandise will be available for you at the finish area, except for 10 year warriors, whose singlets will be sent with their race packs.

* you must state which years you have run so we can check eligibility

Merchandise is only available by pre-ordering.

And what about you?
Everyone has a story. Some should be told. If you would like to tell us a few details about you (the sort of things that we can tell other competitors and the press), we would like to hear from you. Are you one of the seven people who have completed all 20 Adelaide Marathons? Will this be your 10th or better? What is your PB? Whatever….

Name:

Other SARRC Events:
If you want a pre-entry form for any of our other events just tick the appropriate items and we will send you an entry form with your Race Pack or before the event.

• Twilight series: 4.5 km on 26th Jan
• Twilight series: 6 km on 2nd Feb
• Twilight series: 9 km on 9th Feb
• Casual Henley Beach Run Friday 19th Feb
• Piccadilly Springs Glenelg 10 km classic 28th February
• International Women's Day 5K 7th March
• Adelaide Greenbelt Half Marathon and 12 km 2nd May
• 5/10/25 km race and relay 20th June
• 6/15/30 km river run 18th July
• Marathon Festival 22nd August
• 10 km time trial and recovery 29th August
• AAC Airport 5/10 km 10th October
• Spring Cross Country 7th November
• Women's Classic 5/10 km 21st November
• Christmas Frolic 5/10 km 5th December
• All of the above events

The Muscular Dystrophy Muscle Team:
details...

Interested?
If so, please return this form with a tick:

Payment Details:
entry fees ...

Payment is by cash or cheque to SA Road Runners Club, OR
charge my BANKCARD / MASTERCARD / VISACARD

- - - - / - - - - / - - - - / - - - -

Expiry Date: ________________

Signature: __________________

Payments:

Competitor's Agreement, Waiver, Release and Acknowledgment:

1. I, whose signature appears below in consideration of and as a condition of acceptance of my entry in this event, for myself, my heirs, executors and administrators, hereby waive all and any claim, right or action which I or they might have for or arising out of loss of my life or injury, damage or loss of any description whatsoever which I may suffer or sustain in the course of or consequent on my entry or participation in the event.
2. This waiver, release and discharge shall be and operate successfully 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, including sponsors, supporting organisations, the SA Police, ASA, the Sports Medicine Association or St Johns Ambulance, and shall so operate whether or not loss, injury or damage is attributable to the act or neglect of any or more of them.
3. I agree to abide by the race rules, and as provided to me before the event, or as amended.
4. I acknowledge the Race Director reserves the right to alter the course and/or race format due to unforeseen circumstances.

Signature of entrant:____________________Date:_______

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