2014 MOPANI RUN/WALK FOR LIFE - CHARITIES FOR LIFE SERIES
CURRIE CUP FEVER 5KM RUN!
ENTRY FORM
In association with the Pumas.
School with the most pre-entries can WIN R2500 CASH.
Company with the most pre-entries can WIN 10 x Pumas VS Blue Bulls tickets (4th October 2014) 13th September 2014 - 06h30 - Mbombela Stadium - Field B at Gate 8
Proceeds go to Hospice.
5km - R40
CLUB: NAME:
SURNAME:
LICENCE NO:
TEMP NO:
CATEGORY:
J
OPEN
40+
50+
AGE:
GENDER:
EMAIL:
TEL (W):
CELL:
TEL (H):
60+ M
WALKER F
SCHOOL: Athletes indemnify the national, provincial and regional bodies, sponsors and organizers of the race against all and any action of whatsoever nature arising out of their participation in the race. Signature of parent/guardian required if athlete is younger than 18 years. I hereby grant the organizers permission to contact me for future events. Pre-enter at Mopani Pharmacy Crossing or Crossing Superspar until 11th September 2014.
WEAR PINK TO SHOW SUPPORT FOR OUR PUMAS! Proceeds go to Hospice.
SIGNATURE
DATE
RULES: 1. Athletes run under the rules of ASA and Athletics Mpumalanga. 2. Referees and Marshalls must be obeyed at all times. Failure to comply with their instructions will lead to immediate disqualification. 3. All runners participate at their own risk and the organizers and sponsors will not be held responsible for any injury, illness or accidents occurring during or as a result of the race. 4. No seconding or escorting by accompanying vehicles or bicycles will be permitted.
Race photographs online at: Run/Walk for Life Nelspruit, Mopani Pharmacy & Show Me Nelspruit
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