REGISTRATION FEES

$21.00 — incluges 100% cotton Tshirt up to September 7, 1991
$24.00 — Late registration up to Septernber 18, 1991 with T-shirt

$31.00 — Same day registration with T-shirt

$ 400 —- 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
156.00 3rd male and female
400.00 top masters female and male
200.00 2nd masters female and male
109.00 top juniors male and female

50.00 top juvenile male and femaie

£00 00 top team

TEAMS:

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

Deadline September 11, 1991
Please altach all team entrants together

CATEGORIES:

Pledge forms available with our sponsors Juvenile male & female, 17+ under
listed beside entry form. Juniors mai2 & fomals 19+ under
Open male (20-39), iomale (20-34)
Masters male ‘40-49), female (35-49)
Seniors male 50+, female 50+

es ee ee ee Ge ee re ES eS EES GUD ED SU GUE? SUR GE omnes cmees ces ee ee es ee ee ee ee ee es ee oe ee ee

|
!
é
|
|

+

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 3J4
(Additional enquiries at 526-9356) EVENT
MF ___ 10K RUN
AGE ON RACE DAY ____ 5K WALK
FOR MASTERS & SENIORS ____ 2K _ KIDWALK
AGE AS OF DEC. 31, 1991 (Must be accompanied by chaperon)
FOR OTHER CATEGORIES —__ ___ AEROBICS
DATE OF BIRTH: YW. MW De
FIRST NAME: ENTRY FEE:

LAST NAME: $___.
TEAM NAME: $ Brunch
CHAPERON NAME: . $____TOTAL

(KIDWALK)

ADDRESS: ————

Street and City

Province and Festal Code

TELEPHONE # DAY ____
EVENING —_____

SPORT SAFETY/ACKNOWLEDGEMENT 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
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 tisk of injury by so participating.

Signature of Applicant ° Signature of Parent/Guardian

[iS] NORTH SHORE

\ 7 CREDIT UNION

iw, “ficaenge Commanily
gntinanny

Segerstar

FE aR