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WILD COAST ULTRA 2012
ENTRY FORM
13th to 18th February 2012
Surname
First Name ID number
Gender male female
Age on race day profession
Postal address
Postcode
Home phone Running club
Work phone ASA number
Cell Province
Fax Are you a Discovery Health member
Email address
T-shirt size Permanent number (5 completed)
Qualifying race How many WCU have you completed?
Entries and conditions.
Entries must be received by 8th December 2011.
Runner’s entry fee is R5600.
Entrants must be at least 18yrs old on date of event.
Entrants aged 18 to 21 are to have their guardian sign the entry form.
When entries close, more detailed information regarding logistics will be supplied with basic rules and points for consideration during the event. Maps will be handed out at the start.
There will be emergency services on standby but participants must be fit, healthy and able to complete the event safely without aid.
All competitors must have medical cover which includes emergency evacuation. Medical and evacuation costs are for runners expense.
Should the course doctor declare any participant unfit to continue, he or she must withdraw from the event.
Runners must be able to negotiate river crossings.
Basic map reading ability is essential.
Environmental awareness is non negotiable.
Entrants must have completed a marathon, 35k trail or similar endurance event run in the last 6 months. This is a serious challenge. Due to the nature of the trail this event should be considered extreme. Other events will also be considered for qualifying, contact Dave.
Check conditions of cancellation in race information.
Email entries to davegassner@live.co.za, fax to 0866153145 or post entries to: Dave Gassner, 33 Jefferson Road, Milkwood Park, 7975. Telephone 0768179058, 0217855911, fax 086 615 3145 with proof of payment.
Deposit into account :
Electronic transfer to ABSA account 90 6469 4191, Amatola Trail Run, branch code 632005. Put your name on the transfer for reference.
It is not necessary to be a member of a running club or to run in club colours.
Photographs or videos taken during the event may be used for advertising purposes.
The only prize is the good fortune of being able to participate.
Indemnity and Waiver:
I do hereby release and discharge the organiser, any and all sponsors, volunteers, any local or government authorities from any claim, damage or property loss that I may suffer arising from my participation in this event. I accept that this is an extreme challenge and declare that I am physically fit and sufficiently trained to participate and assume all risks for such participation. I accept all rules, conditions and regulations.
Signature of Entrant or Guardian. .................................................................
Date. ..................................................................