KKNSTR Application for Entry - Saturday July 12th, 2008 Name: ____________________________________________________________________________ Address: _________________________________________________________________________ City: _______________________ Prov./State: _______________Country: _______________ Postal/Zip Code:__________ Phone: (H):___________ (W):__________ (Cell):__________ E-mail: ____________________________________________________________ Birth Year: ______ Month: _____ Day: _____ Age on Race Day: _____ Sex: M __ F __ T-shirt size: S __ M __ L __ XL __ Athletic Background No. Ultras: ___ No. marathons: ___ No.KKNSTR finishes: ___ No. Ironmans: ___ 50-mi PR: _____ PR: ______ PR: ______ PR: ______ Other Athletic Achievements: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Race Management reserves the right to deny entry to any runners not demonstrating an appropriate background in endurance activities which would allow them to complete the race in a safe and timely manner. Special Considerations Race Management reserves the right to admit additional runners who may enhance the competitive aspect of the race, or have contributed significantly to the organization of the race or the sport. If you feel you merit special consideration for entry on either of these two grounds, please succinctly list the reasons on reverse or attach to entry form. OFFICIAL WAIVER AND RELEASE As a participant in the Knee Knackering North Shore Trail Run on July 12th, 2008, I agree to all rules and will comply with them. I am aware that this type of ultra-endurance trail run may be extremely difficult and hazardous even for well-conditioned athletes under the most favourable conditions. I understand that I should not compete in this run unless I am in excellent physical condition, have trained adequately and have no medical condition that might be worsened by physical activity. Knowing these facts and in consideration of the acceptance of my application to participate in the Knee Knackering North Shore Trail Run, I hereby for myself, my heirs, executors and administrators waive, release and discharge Kelsy Trigg, Enzo Federico, officials, volunteers and all persons connected with this event from claims of liability, for any injuries to me (including but not limited to death). This release extends to all claims unforeseen, known or unknown. Further, I grant irrevocable permission to the Knee Knackering North Shore Trail Run, and any media covering this year's race, and the authorized agents, contractors, and representatives of each, to use my name and likeness in any photographs, videotapes, motion pictures, recordings or any other records of my participation in this event for any purpose.
_______________________________________________________ ________________________ SIGNATURE OF APPLICANT (PARENT OR GUARDIAN IF UNDER 18) DATE