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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____
Have you run the ITT32km in the last 10 years? Yes____ No____
How many times? ________________
What is your best time?_____________________
Occupation: _____________________
Please check [ ] if you wish to be an Early Starter (7 am).
Release Waiver and Indemnity
To
participate in the Iroquoia Trail Test on Saturday August 22th,
2009, 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, The City of Burlington, Halton District School Board, 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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