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    11th LSR International Marathon - Registration Form

    Uploaded by

    thebigbee
    This document contains an official entry form for the 11th Colombo Marathon race in Sri Lanka. It requests information such as the participant's name, address, date of birth, gender, t-shirt size. It also contains waiver statements acknowledging the risks and agreeing to the rules of the race. There are different entry fees listed depending on when the form and payment are submitted, with late fees applying after August 31st. The entry fee covers participation in the full or half marathon races.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    11th LSR International Marathon - Registration Form

    Uploaded by

    thebigbee
    32 views2 pages
    This document contains an official entry form for the 11th Colombo Marathon race in Sri Lanka. It requests information such as the participant's name, address, date of birth, gender, t-shirt size. It also contains waiver statements acknowledging the risks and agreeing to the rules of the race. There are different entry fees listed depending on when the form and payment are submitted, with late fees applying after August 31st. The entry fee covers participation in the full or half marathon races.

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    11th LSR International Marathon_Registration Form

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    This document contains an official entry form for the 11th Colombo Marathon race in Sri Lanka. It requests information such as the participant's name, address, date of birth, gender, t-shirt size. It also contains waiver statements acknowledging the risks and agreeing to the rules of the race. There are different entry fees listed depending on when the form and payment are submitted, with late fees applying after August 31st. The entry fee covers participation in the full or half marathon races.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    32 views2 pages

    11th LSR International Marathon - Registration Form

    Uploaded by

    thebigbee
    This document contains an official entry form for the 11th Colombo Marathon race in Sri Lanka. It requests information such as the participant's name, address, date of birth, gender, t-shirt size. It also contains waiver statements acknowledging the risks and agreeing to the rules of the race. There are different entry fees listed depending on when the form and payment are submitted, with late fees applying after August 31st. The entry fee covers participation in the full or half marathon races.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    11th COLOMBO MARATHON.

    OFFICIAL ENTRY FORM


    AGE DATE OF BIRTH
    MONTH

    IS THIS YOUR FIRST MARATHON?

    DAY LAST NAME (Family Name)

    YEAR

    MALE

    FEMALE

    YES NO PREVIOUS BEST TIME : FIRST NAME ( Given Name )

    ADDRESS(Use one block for each number and letter, skip a block between words ) CITY COUNTRY
    STATE

    ZIP CODE

    PLACE OF BIRTH

    RACE CATEGORY
    Full Marathon Half Marathon Fun Run Fun Run Veteran ( over 50 ) 10km 05km Full & Half Open Open Open Open Open Men / Women Men Men Men Men / / / / Women Women Women Women

    To pay with credit card, please complete this section.: (If paying with credit card you may fax or mail in entry form) CREDIT CARD CARD ACCOUNT NUMBER VISA MASTER CARD Month EXPIRY DATE Year

    FINISHERS CREW NECK T-SHIRT SIZE


    (For Finishers only)

    SMALL MEDIUM LARGE X-LARGE


    XX-LARGE

    CARD HOLDERS NAME

    CARD HOLDERS SIGNATURE ----

    ---------------------------------------------------------------------------------------

    REGISTRATION AT COLOMBO 1st OCTOBER 2011 AMOUNT DUE


    SEE CHART TO LEFT FOR ENTRY

    ENTRY FEE BY 31st Aug. 2011 ENTRY FEE US $ 50

    LATE ENTRY FEE AFTER 31st Aug 2011 US $ 100

    US $ ...................

    FEE AMOUNT

    NOTE: No written confirmation card will be mailed if entry is received after . 15th September 2011. After 15th September 2011- Hand carry Entry & Fee to Visual Registration at Colombo. No baby carriages , in-line skates, roller skates, skate boards, bicycles, etc. will be allowed on the course on the race day.

    Return to: Lanka Sportreizen 29-B S.De.S Jayasinghe Mawatha, Kalubowila Dehiwala ,Sri Lanka

    Tel: 00 94 1 2824500 / 2824955 WAIVER AND RELEASE STATEMENT : I AGREE to comply with the rules , regulations , and event instructions of the Colombo MARATHON I UNDERSTAND that running a marathon is a potentially hazardous activity and can result in serious injury or death. I am aware of and expressly assume all risks associated with running in the event , including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and humidity, traffic, and the conditions of the road. IN CONSIDERATION of your accepting this entry, I for myself and anyone entitled to act on my behalf, waive and release from any and all claims for injuries and damages I may have against the Organisers of the Colombo Marathon including all other related agencies in Sri Lanka, the Co- Sponsors , the Officials , the agents and representatives of the above and related agencies caused by the negligence of any of them arising out of my participation in this event, including pre and post race activities I ATTEST that I am physically fit and have sufficiently trained for completion of the Colombo Marathon. I CONSENT to receive medical treatment which may be advisable in the event of illness or injuries suffered by me during this event, and I agree to pay for the costs of my medical treatment. I GIVE PERMISSION for the free use of my name , voice or picture in any broadcast, telecast, advertising promotion or other account of this event Signature ......................................................... Date......................................... Signature of Parent if entrant is under 18 years age .......................................................................... Date ........................................ Fax: 00 94 1 2826125

    Europe All Sri Lankan Air Line Offices.

    IF AN ENTRY HAS ALREADY BEEN FAXED , DO NOT MAIL ORIGINAL. If FAXING entry include, Credit Card info. Make Cheque or Money Order payable to: Lanka Sportreizen 29-B S.De.S Jayasinghe Mawatha, Kalubowila Dehiwala ,Sri Lanka Entry Fee is NON - TRANSFERABLE and NON - REFUNDABLE Residence Telephone : Business Telephone :

    INCOMPLETE OR ILLEGIBLE FORMS DELAY YOUR ENTRY

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