The Michael Dunahee Keep the Hope Alive Drive 2005 by alj19178


									                              The Michael Dunahee "Keep the Hope Alive Drive 2010”
                                                            5km Family Fun Run/Walk

                                                 SUNDAY April 4, 2010 @ 10am

                                   Esquimalt Curling Rink, 1151 Esquimalt Road

Entry Fees:
Adult:          $20.00 ~ includes T-Shirt or Tank
Children:       $15.00 ~ includes T-Shirt or Tank
Families:       $55.00 (includes 5 T-Shirt or Tank - $10.00 each additional T-Shirt)
Corporate:      $155.00 (includes 10 T-Shirt or Tank - $10.00 each additional T-Shirt)
Entry forms can be picked up at Front Runners (1200 Vancouver Street) or Esquimalt Recreation Centre (527 Fraser St).
Please mail completed entry forms to: 1010 Lyall Street, Victoria BC, V9A 5E9 OR
Drop off at Frontrunners or the Esquimalt Recreation Centre until Friday April 2, 2010
T-Shirts can be picked up on Saturday April 3 from 10am - 1pm @ Esquimalt Recreation Centre

-------------------------------------------------------       Entry Form--------------------------------------------------------------
                 (Surname)                       (Given Name)                     (Initial)
Telephone number: ____________ Date of Birth: _____________ M/F ________________

IMPORTANT: Information for additional entrants must be included to ensure accurate race number registration

Waiver: Upon acceptance of this entry, I hereby for myself, my heirs, executors, waive and release the organizers of this event and its sponsors any and all
rights or claims for damages I may have against them, their representatives, successors and assigns, for any and all illness, injuries and/or losses I may
sustain as a result of my participation in this event.

Signed: _________________________________________ (under 19 must be signed by parent or guardian, unsigned registrations will not be accepted)

Date: ___________________________________________

Method of Payment:
Cheque (payable to the "Keep the Hope Alive Drive”)________ (Amount paid)

Cash ______(Amount paid)

Signature: __________________________

Registration Category:
__ Adult __ Child __ Family (Make sure to submit all names and ages of additional family members)

__ Corporate (Make sure to submit names and ages of all participants)

T-Shirt size: Youth Med ___ Lrg ____ Adult Med ___ Lrg ___XL ____ XXL ____ Tank sizes: ___Small ___ Med __ Large

I WANT TO VOLUNTEER:                     _____ Road Marshall ___ Race Day Registration

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