REGISTRATION FEES

$21.00 — Includes 100% cotton Tshirt up to September 7, 1991
$24.00 — Late registration up to September 18, 1991 with Tshirt
$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 male
300.00 2nd female and male
180.00 3rd male and female
400.00 top masters female and male
200.00 2nd masters female and male
100.00 top juniors male and female

50.00 top juveniie male and female

500.00 top team

TEAMS:

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

Deadline September 11, 1991
Please attach all team entrants together

CATEGORIES:

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

ENTRY FORM: (PLEASE PRINT CLEARLY)

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Mail Forms To: Jeannette Savard, Race Director, clo Sussex Realty Corp. i CHC G
2397 Marine Drive, West Vancouver, V7V 1K9 j Ppiptip?
2996 Lonsdale Ave., North Van. V7N 3J4 i _ DIN

(Additional enquiries at 526-9356) EVENT {

MF —— 10K RUN !

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AGE ON RACE DAY 5K WALK
FOR MASTERS & SENIORS _.. 2K KIDWALK

{Must be accompanied by chaperon)

(i=) NORTH SHORE
[cA CREDIT UNION

Aataciage Communilg-

FOR OTHER CATEGORIES __ —— AEROBICS

DATE OF BIRTH: YW M__ D__
FIRST NAME: ENTRY FEE:

LAST NAME: a $$
TEAM NAME: a $ Brunch
GHAPERON NAME: ee $___TOTAL

(KIDWALK)

ADDRESS: ———

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AGE AS OF DEC. 31, 1991
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Street and City

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Province and Postal Code l
TELEPHONE # DAY .W |
EVENING ]
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SPORT SAFETY/ACKNOWLEDGEMENT OF RISK — PLEASE READ CAREFULLY

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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

I Clubs or recognized organizing societies. |t is understood by me thal the signing of this document is intended to indicate

i that on behalf of myself and/or my child, | assume the shared responsibility and acknowledge the risk of injury by so participating.

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Superstar

‘Signature of Applicant Signature of Pasent/Guardian