REGISTRATION FEES

$21.00 — Includes 100% cotton Tshirt up to September 7, 1931
$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

$800.00 top female and maie
300.00 2nd female and male
150.00 3rd male and female
400.C0 top masters femate and male
200.00 2nd masters female and male
100.00 top juniors male and female

50.00 top juvenile male and female

500.00 top team

TEAMS:

A minimum of 4 entries with top 4 places scoring for the team

Deadiine September 11, 1991
Please attach a!l team entrants together

CATEGORIES:

Pledge forms available with our sponsors Juvenile male & female, 17+ under
listed beside entry form. Juniors male & female 19+ under
Open male (20-39), female (20-34)
Masters male (40-49), female (35-49)
Seniors mate 50+, female 50+

ENTRY FORM: (PLEASE PRINT CLEARLY)

Mail Forms To: Jeannette Savard, Race Director, clo Sussex Realty Corp.
2397 Marine Drive, West Vancouver, V7V 1K9
2996 Lonsdale Ave., North Van. V7N 3J4
(Additional enquiries at 526-9356) EVENT

M__F_ ___ 10K RUN
AGE ON RACE DAY 5K WALK
FOR MASTERS & SENIORS ___ 2K KIDWALK
AGE AS OF DEC. 31, 1991 {Must be accompanied by chaparon)
FOR OTHER CATEGORIES ___ ____ AEROBICS

DATE OF BIRTH: YI M_W_DL

FIRST NAME: SSS ENTRY FEE:
LAST NAME: . $_

TEAM NAME: a $ Brunch
CHAPERON NAME: ee $___TOTAL

(KIDWALK)

ADDRESS:

ENCH

PpIDHoSy

Street and City

#BROOKS

Provitice and Postal Code

TELEPHONE # DAY
EVENING

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- i $ tf)
ticipating in the programs or activities of the events which are sanctioned/approved by BC. Athletics, its Divisions, its Member | LET'S ‘a
Clubs 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.

a Te |

Signature of Applicant Signature of Parent/Guardian