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Official Entry Form

Instructions: Print this form, fill it in and mail with payment to: INTRAINING Running Centre, 40 High Street, Toowong, QLD 4066. All entrants must sign the declaration.

Name ____________________________________________

Address _________________________________________

PC __________		Date of birth ___/___/___

Phone H___________________W___________________

10km ______5km ______Using an assistant ______

Under 19 ____ 	30 to 39 ____  	50 to 59 ____

19 to 29   ____ 40 to 49  ____	60 & Over ____

• Age prizes to first five in 10km and first three in 5km.
• Overall place winners not eligible for age prizes.

• No race day entries
• Teams of 3

Team/School Name________________________________________

Team members please submit all three forms together.

• Must be signed for entry to be accepted.
• Parent or Guardian must sign if under 18 years of age

In consideration of my entry, I, my heirs, executors and administrators release and forever discharge the Intraining Running and Triathlon Club Inc., the INTRAINING RUNNING Centre P/L, their servants, agents and subcontractors, instrumentalities, and all voluntary community groups assisting with this event, all sponsors producers their agents and representatives, The Qld Police Department, and the Brisbane City Council of all liabilities, claims, damages or costs which I may have against them arising out of, or in any way connected with my participation in the 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 hereby agree that in the event of race cancellation due to storm, inclement weather, wind or any other unforeseeable, or "Act of God" conditions, my entry fee shall be non-refundable. I have carefully read this entry form and agree to abide by all the rules and directions of all race officials on the day of the race.

Signed _________________________________ Date _____/_____/_____

• 10km - $10
• 5km - $10
• Junior Relay - $15 / team

• Discount for Groups of 10 or more.
• Only $8 per person
• Entries must all be in the one envelope

• Indicate size & quantity
• Limited Numbers available.
• Samples can be viewed at the INTRAINING Running Centre

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