sportzhub

1020 Challenge
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Entry Form

Please fill out the following entry form and disclaimer, complete and send to:

Adventure Racing Auckland
PO Box 7329
Wellesley St
Auckland Central

Please make cheques payable to "Adventure Racing Auckland" or deposit fees directly into our account: (Please specify team name)
Adventure Racing Auckland 02-0100-0729624-000.

Category

Race Category [select category]  
20 Hour Challenge 10 Hour Challenge
4 Person Team [select category]  
Open Men Men's Combo
Women's Combo Relay (20 hour challenge only)
2 Person Team [select category]  
Open Men Open Women
Mixed  

Team Information

Team Name
Team Captain

Team Member 1

Name
Address
Phone: Home & Cell
E-Mail address

Team Member 2

Name
Address
Phone: Home & Cell
E-Mail address

Team Member 3

Name
Address
Phone: Home & Cell
E-Mail address

Team Member 4

Name
Address
Phone: Home & Cell
E-Mail address

Team Member 5

Name
Address
Phone: Home & Cell
E-Mail address

Team Member 6

Name
Address
Phone: Home & Cell
E-Mail address

Team Member 7

Name
Address
Phone: Home & Cell
E-Mail address

Team Member 8

Name
Address
Phone: Home & Cell
E-Mail address

Support Crew

Support Crew 1

Name
Address
Phone: Home & Cell
E-Mail address

Support Crew 2

Name
Address
Phone: Home & Cell
E-Mail address

Support Crew 3

Name
Address
Phone: Home & Cell
E-Mail address

Support Crew 4

Name
Address
Phone: Home & Cell
E-Mail address

Entry Fees

20 Hour Entry fee $200 per person
20 Hour Relay Entry fee $100 per person or $500 per team
10 Hour Entry fee $100 per person
Total fee per team (including late entry fee after 18/11/06)

Late Entries

Entries received after November 17th will incur a $15.00 late entry fee per person. Entries close on November 24th.

Cancellation

Any cancellation received within 2 weeks of the event (November 17th) will incur a $50.00 per person administration fee. Any cancellation after November 17th will result in no refund.

LIABILITY RELEASE / DISCLAIMER

(To be signed by Team Captain on behalf of team)
I/we declare we have fully read and understand the rules and conditions of The 1020 Challenge. I/We attest that I/we are fully aware of the risks and hazards involved in participating in this event and I/we understand that participation in the event is at my/our own risk. In consideration of the acceptance of my/our entry fee, I/we do hereby on behalf of my/our heirs, executors, administrators and assignees, release and forever discharge the sponsors of and any and all persons involved in the conduct of The 1020 Challenge from any and all liability whatsoever or claims of damages or actions whatsoever (including negligence) in any manner arising out of my/our participation in The 1020 Challenge.

Team Captain's Signature Date