Vic Falls Marathon

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Entry Form
Surname:		Passport Number:
First Names:		Tel (h):
Postal Address:		Tel (w):
		Cell:
		Fax:
Code:		EMail:
Country:
Emergency Contact Person:
Tel no.

Age Restriction:	Full Marathon: 21 years at time of race Half Marathon: 18 years at time of race Fun Run: Minimum 10 years at time of race
Race:	42.2 km Run: 21.1 km Run: 5 km Run:
Age Group:	Open: 40-49: 50-59: 60-69: 70+:
Gender	Female Male
Please Send Me More Info:
AGE ON RACE DAY :
ADDRESS WHERE YOU WILL BE STAYING IN VIC FALLS DURING RACE :

Where did you hear about the race?
Radio:	(Which One)
News Paper:	(Which One)
Running Magazine:	(Which One)
Poster:	(Which One)
Flyer:	(Which One)
Sport Shop:	(Which One)
Other:	(Which Other)

This registration is based on the event details stated in the itinerary for the VicFalls Marathon 2010. I confirm having read and fully understood and accepted the "terms and conditions" of this contract as more fully set out in attached. I declare that I am eligible to compete as defined by IAAF rules. In signing this booking application, I hereby indemnify and hold harmless Wild Frontiers Pty Ltd, Kaelo Pty Ltd Safari Par Excellence Zimbabwe / Adventure Zone; Wild Horizons Zimbabwe, and all associated sponsors and their employees and agents from all losses and injuries sustained by me. Furthermore, I confirm that I am competent and/or authorised to sign this registration form and agree to the terms and conditions hereto. I further give permission for the free use of my name, voice or picture (still or moving) to be used in any broadcast, telecast, advertising, promotion or any other form of advertising of this and future events.

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