WALLAROO FUN RUN ENTRY FORM

NAME  _____________________________________

ADDRESS  __________________________________

AGE TODAY  _____  SEX M / F   D.O.B.  _________

2km INDIVIDUAL CATEGORIES
Male (   ) U7, (   ) 7-8, (   ) 9-10, (   ) 11-12,
(   ) Open
Female (   ) U7, (   ) 7-8, (   ) 9-10, (   ) 11-12,
(   ) Open

2km "A" TEAM CATEGORIES (min of 2)
(   ) U10 male, (   ) U10 female,
(   ) U13 male, (   ) U13 female

2km "B" TEAM CATEGORIES (min of 2)
(   ) Parent & U13 Child, (   ) Parent & U18 Child

2km "C" TEAM CATEGORY (min 4)  (   ) School

6km INDIVIDUAL FEMALE CATEGORIES
(   ) Under 11, (   ) 11-12, (   ) 13-15, (   ) 16-20,
(   ) 21-30, (   ) 31-40, (   ) 41-50, (   ) Over 50

6km "A" TEAM CATEGORIES (min of 3)
(   ) U13 Male, (   ) U13 Female, (   ) 13-15 Male,
(   ) 13-15 Female, (   ) 16-20 Male, (   ) 16-20 Female,
(   ) Open Male, (   ) Open Female

6km "B" TEAM CATEGORIES (min of 2)
(   ) Husband & Wife, (   ) Parent & Child

10km INDIVIDUAL CATEGORIES
Male (   ) 14-16, (   ) 17-19, (   ) 20-30, (   ) 31-40,
(   ) 41-50, (   ) Over 50

Female (   ) 14-16, (   ) 17-19, (   ) 20-30, (   ) 31-40,
(   ) 41-50, (   ) Over 50

10km "A" TEAM CATEGORIES (min of 3)
(   ) U15 male,   (   ) U15 female
(   ) 16-20 male, (   ) 16-20 female
(   ) Open male, (   ) Open female

10km "B" TEAM CATEGORIES (min of 2)
(   ) Husband & Wife, (   ) Parent & Child

6km INDIVIDUAL MALE CATEGORIES
(   ) U11, (   ) 11-12, (   ) 13-15, (   ) 16-20,
(   ) 21-30, (   ) 31-40, (   ) 41-50, (   ) Over 50

RULES & CONDITIONS
Entries will only be accepted on the official entry form or photocopy, duly completed & signed by the entrant.
Each competitor will run the approved course as directed, will not accept outside assistance & will accept the
judges decision as final. No competitor will be awarded a place unless wearing an official competitor's chest
number. The organisers reserve the right to cancel or reject any entry at any time, or combine or delete
categories if insufficient entries are received. The run is only for competitors taking part in sport as
amateurs and signing the declaration to this effect on the entry form. 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. An individual may nominate for only 1 Category "A" Team in each run and may
not nominate in a Category "B" team in the same event. Placings in team events will be decided by the aggregate
times of: "A" - first 3 runners in each team to finish; "B" - first 2 runners in each team to finish. Only 3
awards will be given to the winning "A" Team, only 2 awards to the winning "B" Team and 4 to the winning "C"
Team. Each member of the "C" Team Category must be from the same school. Supporters must not follow the
competitors. It is up to the competitors to ensure that their time and place are recorded correctly. A trophy
for the 2km run can only be won from the U7 - U12 agegroups.

DECLARATION
I, the undersigned, in consideration of, and as a condition of acceptance of my entry in the Wallaroo 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  (by the entrant)  __________________________

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

I certify that I am the Parent/Guardian of  ___________________________  who is  _____  years of age

and has my consent to run in this event. SIGNED  _______________________