Are you attending this event?

Yes No Maybe

Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Course*

Long

Short

Phone Number*

Paid Online ?*

Yes

No

Amount to pay*

Member-1 map- Maximum 2 adults - $ 5

Member part of family entry max $15 per family

NON Member-1 map- Maximum 2 adults - $ 10

NON member part of family entry maximum $25 per family

Team member names ( in addition to yourself) Max 255 characters

Safety Notice

- Please be aware that the event is occurring on public roads
- Be aware of traffic
- Be aware of vehicles exiting driveways
- Please stay out of private property
- All minors to be accompanied by an adult

I confirm that I have read the above Event Waiver in its entirety.*

I agree to the Event Waiver.*

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