Shore to Shore Road Race

2009

Online Registration Form

***Release Form***

 The Shore to Shore Road Race is open to any runner or walker.

It is sponsored by Wiarton District Family Literacy, Rotary Club of Wiarton, and the Ontario Road Runners Association, which reserve the right to refuse entry to any applicant not of legal age, unless authorized by a parent or guardian.

The sponsoring clubs will not be held responsible for any injury or illness which may result from participation in this race.

Competitors participate at their own risk.

By submitting this entry, I acknowledge having read and agree to the above terms of this release.

Online and      e-mail payments will be Accepted until Aug 2nd 12:00 Midnight Mail-ins must be received by July 25th.

Please Read

Once you have filled out and submitted your information you will see a page with the information you submitted, at the bottom left of the page is a link to go to the payment instructions. Click link and follow the instructions.

PayPal  help available here.

**Gender

Runner / Walker

Title

**First Name

**Last Name

**Date of Birth  

Address 1

Address 2

**City/Town

Prov / State

Postal/Zip Code

Country

Phone

**E-mail Address

** Have you read and agreed to the conditions of the Release Form below**

If Participant is under 18 years of age NAME OF PARENT OR GUARDIAN IS REQUIRED

T-Shirt size

ORA/OTFA #

Results Sent?

NAME OF PARENT OR GUARDIAN

How would you like to pay?

Yes / No

DD/MM/YYYY

Wiarton District Family Literacy Association

If you have already sent in your registration please do not use this form.

 

Please Download your pledge sheets here

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