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SEPTEMBER 22, 1991

. 10K Run, a 5K Walk, a 2K ‘Kidwalk’'
Events: and an aerobic workout

8:00am — 5K Walk & the 2K ‘Kidwalk'

Times: 8:30am — 10K Run
9:15am —- Aerobic werkout

. The North Shore Winter Club
Place: 1325 Keith Road, North Vancouver

Funds raised go to the
Lions Gate Hospital Foundation & the
Lions Gate Medical Research Foundation

Pledge forms available with our sponsors
listed beside entry form.

Wecinesday, Septeinue: 4, 7297 "1 L. usc News - 64

REGISTRATION FEES

$21.00 — includes 100% cotton T-shirt up to September 7, 1991
$24.00 — Late registration up to September 18, 1991 with T-shirt
$31.00 — Same day registration with Tshirt
$ 4.00 — Optional Brunch
$ 2.00 — Discount to all BC. Athletic Members

or equivalent

AWARDS

top female and male

2nd female and male

3rd male and female

top masters female and male
2nd masters female and male
top juniors male and female
top juvenile male and female
top team

A minimum of 4 entries with top 4 places scoring for the team
Deadline September 11, 1991
Please attach all team entrants together

CATEGORIES:

Juvenile male & female, 17+ under
Juniors male & female 19+ under
Open male (20-39). female (20-34)
Masters male (40-49), female (35-49)
Seniors male 50+. femate 50+

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ENTRY FORM: (PLEASE PRINT CLEARLY)

Mail Forms To: Jeannette Savard, Race Director, c/o Sussex Realty Corp.
2397 Marine Drive, West Vancouver, V7V 1K9
2996 Lonsdale Ave., North Van. V7N 34
(Additional enquiries at 526-9356) EVENT

AGE ON RACE DAY

FOR MASTERS & SENIORS —— 2K KIDWALK

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AGE AS OF DEC. 31, 1991
DATE OF BIRTH: Y__M___D___
FIRST NAME:
LAST NAME:
TEAM NAME:
CHAPERON NAME:

(KIDWALK)

ADDRESS:

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Street and City
I Province and Postal Code
{| TELEPHONE # DAY

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SPORT SAFETYIACKNOWLEDGEMENT OF RISK — PLEASE READ CAREFULLY

The responsibility for Sport Safety must be shared by all. [, the undersigned, am aware that there is a certain risk of injury
involved in my own or my child's participation in Sport, either while travelling to or from the event, or while attending or par-
ticipating in the programs or activities of the events which are sanctioned/approved by BC. Athletics, its Divisions, its Member
Ciubs or recognized organizing societies. It is understood by me that the signing of this document is intended to indicate
that on behalf of myself and/or my child, | assume the shared responsibility and acknowledge the risk of injury by so participating.

Signature of Applicant Signature of Parent/Guardian

FOR OTHER CATEGORIES ___ —— AEROBICS

Q’CKig
Ppiplng

ste 1D

—— 10K RUN
-——. 5K WALK

(Must be accompanied by chaperon}
Nee
CREDIT U

sthanh ing + Communilg”
ENTRY FEE: Ke —

$___
$ Brunch
$___TOTAL

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