Entry Form 2022 Your DetailsName* First Last Date of Birth* DD slash MM slash YYYY Gender* Male Female Address* Street Address Address Line 2 City AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Phone*Emergency Contact Name* First Last Emergency Contact Phone*Entry DetailsEntry Type* Run Walk Select Event Type* Marathon Run / Walk - $50.00 1/2 Marathon Run / Walk - $40.00 1/4 Marathon Run / Walk - $25.00 5km Fun Run / Walk - $15.00 5km Relay Run / Walk - $60.00 1.2km Kids Fun-Run-Athon $5.00 T ShirtNoneMens SMens MMens LMens XLMens 2XLMens 3XLMens 5XLWomens 4Womens 6Womens 8Womens 10Womens 12Womens 14Womens 16Womens 18Womens 20Womens 22Womens 24$50 Each2019 Design (2022 design will be available soon) School* Estimated Time Team 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, and I am responsible for my own actions at all times. I hereby release the event organisers, the Wanganui Harrier Club, volunteers, 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 this event and its related activities. 2. Transfers: My accepted entry may be transferred to another person, distance or category, as long as any increase in fees is paid in full. Transfers must be done officially by contacting the event organiser. Entries are transferable to another participant until 6 December 2022. After 6 December 2022 all person to person transfers and all distance or category transfers must be done at Race Pack Pick Up. Transfers do not apply to future years, or if a 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 2022 will receive 75% of their entry fee. Entry fee refunds requested from 1 November 2022 to 6 December 2022 will receive 50% of their entry fee. Unfortunately, entry fees are non-refundable after 6 December 2022. No entry fees will be refunded after this date (including any refund request on downgrade between event distances). 4. In the event of personal circumstances preventing me from participating, my total entry fee is non-refundable. The event organiser may alter the event without refund. If the event is cancelled, entrants will be offered a transfer to 2023 or a refund less a 10% admin fee. 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 NZ Police, Event Officials/Marshals and First Aid Personnel. 8.I understand that the course is run on public roads and is open to vehicular traffic. At all times I must watch for traffic and obey traffic management instructions. Course marshals are in place for direction only. Where traffic is involved, I must take responsibility for my own decisions and actions. 9. If a walker is judged to be other than walking, they will be classed as a runner. 10. Marathon and Half Marathon entrants are recommended to be 16 years of age and over. 11. Quarter Marathon entrants are recommended to be 12 years of age or older. 12. 1.2km Kids Fun-Run-Athon entrants must be 13 years of age or under. 13. Participants under 16 years of age must be entered by their parent/guardian. Participants under 7 years of age must be accompanied on the course by a parent or caregiver (14 years old +). 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 / PayPal Bank Deposit