Online entries close on midnight 6th December See you at the start line. Your DetailsName* First Last Date of Birth* Gender*MaleFemaleAddress* Street Address Address Line 2 City AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email* Phone*Emergency Contact Name* First Last Emergency Contact Phone*Entry DetailsEntry Type*RunWalkSelect Event Type*Marathon Run / Walk - $60.001/2 Marathon Run / Walk - $50.0010km Run / Walk - $35.005km Fun Run / Walk - $15.00Corporate Relay Run / Walk - $80.00Kids 1.2km Fun-Run-Athon $5.00T ShirtNoneMens SMens MMens LMens XLMens 2XLMens 3XLMens 5XLWomens 4Womens 6Womens 8Womens 10Womens 12Womens 14Womens 16Womens 18Womens 20Womens 22Womens 24SchoolEstimated TimeTeam Name*Team Member 1* First Last Team Member 2* First Last Team Member 3* First Last Team Member 4* First Last To Bank and Account: Wanganui Harrier ClubANZ 11-6840-0683200-11 Enter the following details as a reference please: The entrant's Surname followed by Initials and '3BM' (if fits) or, if entering the Corporate Relay, the Team Name and '3BM'.Declaration, Disclaimer and Terms & Conditions*1. I acknowledge that I compete at my own risk. I hereby release the event manager and Athletics New Zealand, their officers, directors, volunteers, employees, sponsors or any party associated with the event of any liability, financial or otherwise, which might arise whether or not by negligence, from any direct or indirect loss, injury or death which might be sustained by me or any other party directly or indirectly associated with me, from my intended or actual participation in the event and its related activities. 2. Transfers: My accepted entry will be transferred to another person, distance or category, as long as any increase in fees, has been paid in full. After 6 December 2018 there are no person to person transfers, and all distance or category transfers must be done at registration. Transfers do not apply to future years, or if new entrant is ineligible due to age. 3. Refunds: Requests for refunds must be notified to the organiser by email. Entry fee refunds requested up until 31 October 2018 will receive 75% of their entry fee. Entry fee refunds requested from 31 October 2018 to 6 December 2018 will receive 50% of their entry fee. Unfortunately, entry fees are non-refundable after 6 December 2018. No entry fees will be refunded after this date (including, for the avoidance of doubt, any refund request on downgrade between event distances). 4. In the event of any ‘Act of God’ causing a cancellation of the event, or personal circumstances preventing me from participating, my total entry fee is non-refundable. 5. I acknowledge that the Event Organisers have absolute discretion in accepting my entry, which may be revoked at any time. 6. I authorise any information given on this entry form to be used for promotional and/or results purposes pursuant to the privacy act 1993. 7. I agree to abide by the instructions of race officials, NZ Police and Medical Staff. 8. I understand that the course is partially run on public roads and is open to vehicular traffic. Competitors / entrants must be no more than two abreast at any time. 9. If a walker is judged to be other than walking, they will be classed as a runner. 10. Marathon and Half Marathon competitors / entrants are to be 16 years of age and over. 11. 10km competitors / entrants are to be 12 years of age or older. 12. 1.2km Fun-Run-Athon competitors/entrants must be 13 years of age or under. 13. Participants under 7 years of age must be accompanied by a parent or caregiver. 14. Once each race has started there is no changing of events. 15. I have read and agree to all the safety information, rules and conditions above and on the accompanying web pages. I agree to and acknowledge the terms listed above. Total $ 0.00 Payment Method*Credit Card / PayPalBank Deposit This iframe contains the logic required to handle Ajax powered Gravity Forms.