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Holroyd Family Festival 10km Fun Run
Official Entry Form

Instructions: Print this form and forward with cheque to:
The Fun Run Organiser, C/- Starr Partners (Merrylands),
139 Merrylands Road, Merrylands, NSW 2160. (Phone: 9682-3333)

Enclosed entry fee payable to "THE ORGANISER STARR PARTNERS (MERRYLANDS)"
(Entries close 8.30 a.m. day of Run for 9 a.m. start.)

Disabled Entrant YES / NO    Surname__________________  Christian Name:__________________

Address:__________________________    Post Code:________________________

Telephone No: (____)______________    Age:_____           Sex:_____

If you are under 18 years of age, this consent form must be signed by your parent or guardian.

I CERTIFY that I am Parent/Guardian of____________________who is____years of age and

he/she has my consent to run in  the "FESTIVAL TEN" on Sunday, 20th April, 1997.  

Signed____________________Parent/Guardian

Ladies Team/Men's Team:____________________         Name of Team:______________________________

Have you completed in this event before YES / NO    Which Year_____

PLEASE NOTE: Corporate entries either individual or team are not allowed. The organiser reserves the right to reject any entry.

• I, the undersigned, in consideration of and as a condition of acceptance of my entry in the "FESTIVAL TEN" 10km foot race, for myself, my heirs, executors and administrators hereby waive all and any claim right of cause of action which I or they might otherwise have for 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 upon my entry or participation in the 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.
• The judges decision will be final and no correspondence or disputes entertained. All entrants must sign (if under 18, the parent or guardian of the entrant must sign).

AMATEUR STATUS: I declare I take part in sport only as an amateur and NOT for any monetary consideration.

SIGNED (by the entrant)____________________DATE___/___/___

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