Registration Form

Registration Form

KZ Run\Walk for Maisy & Shannon
Registration Form

* Indicates a mandatory field

Choose Event type:*

Last name:*

First name:*

Address line 1:*

Address line 2:

City:*

Province/ State:*

Postal Code:*

Country:*

Daytime Phone:*

Evening Phone:

Email:*

Year: :*

Date of Birth:*

Age, as of June 19th,11: *

Male

Sex: *

Female

Souvenir Shirt :*

Yes

T-Shirt Sizes:

Parent or Guardian Name, Youth 17 & under

Please read waiver carefully and check the box below

This is my entry for the KZ Run/Walk for Maisy and Shannon. I recognize that I am participating at my own expense in this event and I waive all claims against the organizers of the KZ Run/Walk for Maisy and Shannon, 384 Queen Mary Street, Ottawa, ON K1K1W7, the Kitigan Zibi School, Kitigan Zibi Anishinabeg, the event sponsors, and all other participating individuals or agencies that deals with any personal loss or bodily injury to myself, including death, resulting from my participation in this event.

I acknowledge that my participation in this event involves risks to my health and safety, including death, and I willingly accept these risks.

I acknowledge that I understand the risks associated with this competition and I acknowledge myself to be healthy and fit enough to participate in it.

I understand that my email is provided for identification and communication purposes only, and I acknowledge that the organizers of the KZ Run/Walk for Maisy and Shannon will not sell its email lists to any third parties.

I agree to permit the event organizers to use any photo taken of me during the event for promotional purposes on its website, in the media or in special promotions.

I have read and agree to the above waiver. *

After choosing the submit button above, please come back to this page
to choose your event and press the "Add to Cart" button below.

Notes:
* If you would like to submit a group registration, please email penny@findmaisyandshannon.com.
* Online registration closes June 16th, 2011 by 5:00pm.
* All fees are 100% non-refundable.
* The fees listed above do not include the paypal processing fee.
* Fees listed in the form below are early bird rates. Fees will change to regular rates on May 1st,
2011 with the exception of youth 17 and under.
* Please email mjacko@findmaisyandshannon.com if you experience any technical difficulties when
registering.

Registration Fees

Event

Up until May 1, 2011

May 2- June 17, 2011

June 18-19, 2011

$10

$20

$30

$40

10K

$30

$40

$50

* Please Note that youth, 17 and under, are always subject to early bird registration fees.

Sunday June 19th, 2011

Please follow these steps to enter the KZ Run\Walk for Maisy and Shannon via online.
1.         Proceed to fill in the required fields (marked with a red asterisk) in the Registration Form below and
            click on the submit button.
2.         After pressing the submit button, proceed back to this page to choose your event below then click
          on the "Add to Cart button" to proceed to the secured paypal page.
3.         Confirmation of this online entry form will be provided by email, in addition to your paypal receipt.

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