P6 Entry Form

INSTRUCTIONS:
Complete on-line, submit and pay by Credit Card or into our bank account (noting your surname as a reference)
OR
Print out and complete the entry form below and post with payment to (cheques also payable to):
Lactic Turkey Events,
PO Box 60 540, Titirangi, Auckland

Mandatory Field


Team Captain First Name:		Team Captain Last Name:
Team Captain E-mail:		Team Captain Address
Team Captain Age		Team Captain Phone

Team Name

Team Gender Category Men Women Mixed Corporate (must include at least 1 woman) School Team Family

Team Age Category Junior (under 19) Open Veteran (40yrs +) Corporate (includes at least 1 woman) School Team Family

	NAME	EMAIL	AGE
Team Member 2
Team Member 3
Team Member 4


Junior and senior citizens over 80 years ($65 per person)
Open $95 per person
		Total Paid

Payment Method	Cheque Direct into Lactic Turkey Bank (Please pay into our Kiwi Bank account called "Lactic Turkey Events Limited" Account number 38-9005-0018737-00) Credit Card - you'll have a chance to pay by credit card on the next screen once you have submitted this entry info

Date Paid		Reference of Payment	enter me now

How did you hear about this event?

LATE ENTRY FEE APPLIES IF RECEIVED AFTER 13 OCTOBER 2010

Confirmation of entry is by e mail to team captain.

Waiver you will sign on the day:

I declare that I have fully read and understand the rules and conditions of the P6 Adventure Race. I attest that I am fully aware of the risks and hazards involved in participating in this event and I understand that participation in the event is at my/our own risk. In consideration of the acceptance of my entry fee, I do hereby on behalf of my heirs, executors, administrators and assignees release and forever discharge the sponsors of, landowners and any and all persons involved in the conduct of the P6 Adventure Race from any and all liability whatsoever or claims of damages or actions whatsoever (including negligence) in any manner arising out of my participation in the P6 Adventure Race. I agree that the P6 Adventure Race and any sponsor of this event may use information contained in this form for purposes connected with the event, and to provide details of other products, services and events to me from time to time. I understand that I have rights under the Privacy Act 1993 to access and correct any information held about me.

Refund Policy - Entries cancelled greater than two weeks before an event will receive a refund less a $10 administration fee. Entries cancelled within two weeks of the event can be used as a credit for another Lactic Turkey event or can be refunded less a $20 administration charge. No refunds will be given for cancellations within 48 hours of the event day. Refunds will be paid direct into a bank account as nominated by the participant.