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REGISTRATION
FORM
Name: _____________________________________________________________________
Address: __________________________________________________________________
City: ______________________________ Prov/State: _______ Postal/ZIP:_______
Phone: (_____)_____________________ E-Mail:________________________________
Date of Birth MM____ DD____ YY____ Sex: Male____ Female____
Age on Race Day: _______
Age on race day (Category Prizes) <40___ 40-49___ 50plus___ (place check mark)
Age on July 31st/08(Series Points)<40___ 40-49___ 50plus___ (place check mark)
First Time Running this Event? _____ yes ____ no
CMAA No: ___________________ or $5 Race Day CMAA Membership: ___ yes ___ no
(Note: Runners must be 35 & over to qualify for CMAA Awards. Add $5 to entry fee for a Race Day CMAA Membership.)
Food for Guests: How many: @ $20 each ______ and/or @ $5 each ______
(Please include guest food payment with the entry fee. Guests will be given cards as proof of payment.)
ORA/OTFA No.: _____________________ Shirt Size: S M L XL
Previous Best Marathon/Ultra Time_________________________________________
Occupation: _____________________(optional)
Release
Waiver and Indemnity
To participate in the Ottawa International 24 Hour
Self-Transcendence Race on
Saturday September 13th, 2008, I accept,
have read and
understand all rules and regulations of the Ontario Ultra/Trail Series
and of this specific event that I am entering and will comply fully
with them. I am aware that a run of the distance and conditions
specified for the specific event I am entering, may be extremely
difficult and hazardous even for well-conditioned athletes under the
most favourable conditions. I am also aware of the risks of adverse
weather conditions, which may accompany the event on the day of my
participation. I understand that I should not participate in this event
unless: (1) I am in excellent physical condition, (2) I have trained
adequately for this event, and (3) I have no medical condition that
might be worsened by vigorous activity. Knowing these facts, and in
consideration of your accepting this entry, I hereby for myself, my
heirs, executors and administrators waive, release and discharge the
Ontario Ultra/Trail Series and all its officials, the Ontario Road
Runners Association, The Ontario Track and Field Association, all of
the various sponsors, the Race Director and their staff, agents,
officials, Deerhurst Web, volunteers, or any other person involved in
this specific event, and all government or private jurisdictions in
which the specific event may take place including all Ontario Ultra and
Trail events in the 2008 series, but not limited to the Hamilton Region
Conservation Authority, the City of Kingston, the Royal Military
College, City of Pickering, Dell Management, Metro Toronto Conservation
Authority, The Ontario Provincial Government, The Bruce Trail
Association, The Halton Conservation Authority, The city of Milton,
Kelso Conservation Area, The Haliburton Forest & Wildlife
Reserve Ltd, The City of Ottawa, The City of London, Upper Thames River
Conservation Authority, Fanshawe Conservation Area, The City of
Toronto, The City of Cambridge, The Grand River Conservation Authority,
The Region of Waterloo, The City of Niagara Falls, The Region of
Niagara, Niagara-On-The-Lake, Runner's Den Owen Sound, The Corporation
of the City of Owen
Sound, Township of
Georgian Bluffs, Gray Sauble Conservation Authority, Sydenham
Bruce trail
club, Simcoe County, Dufferin County, Clearview Township, Mulmur
Township, Messrs Charlie Tidd, Cliff Weston and Stuart Lombard from any
and all claims of liability, for any and all injuries to me (including,
but not limited to death), or my property arising out of, or in
connection with, this event and covenant not to sue for damages with
respect thereto. This release extends to all claims of every kind and
nature whether foreseen or unforeseen, known or unknown. I declare that
I have sufficiently trained to participate in this event and assume all
risks associated with such participation in such an event. The race
director (s) and/or executive members of the Ontario Ultra/Trail Series
Board hold the right to cancel any event should weather or any other
condition make it potentially unsafe for the participants and/or event
volunteers, and reserve the right to remove any participant from a race
for any reason including but not limited to infraction of rules or for
medical reasons. Finally, I hereby grant my permission to the race
organizers and Ontario Ultra and Trail Series sponsors to use my name,
mailing address and any photographs, videotapes, recordings, or any
record of my participation in this event for any purpose. My personal
information will not be sold by either the Ontario Ultra and Trail
Series or their sponsors.
Signature________________________________
Date _____________________
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