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DYAB KAPAMILYA RUN

OFFICIAL ENTRY FORM


June 13, 2010 EARLY BIRD REG: PHP 200 – JUNE 1 to JUNE 7, 2010
ASIATOWN IT PARK REGULAR REG: PHP 250 – June 8 to 11
ASSEMBLY TIME: 4:45 AM LATE REG: PHP 300 – June 12 to 13
RACE STARTS AT: 5:30 AM

CATEGORY: 1.6 KM 7 KM 15 KM

SINGLET SIZE: SMALL____ MEDIUM____ LARGE____ X-LARGE____

____________________ __________________________ ________ __________________


LAST NAME FIRST NAME M.I. NATIONALITY

____________________________________________________________________________________
ADDRESS: NUMBER, STREET, CITY, PROVINCE

_______________ _______ _______ ____________________ __________________


DATE OF BIRTH AGE SEX TEAM/CLUB/BRGY. CONTACT NUMBER
_______________________________________________________________________________________

WAIVER OF LIABILITY
By signing the Entry Form and participating in the DYAB KAPAMILYA RUN, I agree to abide by the rules of this
event and certify that I am fully and physically fit and adequately trained to finish the race and that I fully
accept the following Waiver of Liability: I understand that participating in this event may involve real risk of
serious injury or even death from various causes including but not limited to falls, over exertion, dehydration,
contact with other participants, spectators, road users, effect of weather and conditions of the road. I
voluntarily assume all risk associated with my participation in the event or any activity associated with it. I, in
consideration of and as a condition of the acceptance of this entry for myself, my executors, administrators,
heirs, next of kin hereby waive, release and forever discharge the event organizers, sponsors, promoters,
agents or servants from all claims, actions or damages that I may have against them howsoever cause, arising
out of or in any way connected with my participation in this event. I authorize the use of my name, voice and
picture and any information provided by myself on this entry form to be used without payment in any
broadcast, telecast, promotion or advertising. I also agree that the information that I have provided may be
used by the event organizer for the purpose of promoting future and other events for the promotion of face
sponsors, products and services.

Signature over Printed Name ____________________________ Date ______________

Parent /Guardian Signature (if under 18) _______________________________

Registration fee includes Singlet, Race #, Route map, & snacks


Registration Center: Abellana Sports center, Runnr Ayala & Holiday Gym & Spa
Distribution center: Athletics Dept. Abellana Sports Center: Look for Lyle
Note: To ensure singlet size, pls. register on or before June 9 afterwhich we cannot guarantee your requested singlet size anymore.

___________________________________________________ ___________________ _________________


LAST NAME, FIRST NAME M.I. CONTACT NUMBER CLUB/COMPANY

______________________________________________________________________ ______________________________
ADDRESS NUMBER, STREET, CITY, PROVINCE RECEIVED BY
CATEGORY: 1.6 KM 7 KM 15 KM

SINGLET SIZE: SMALL____ MEDIUM____ LARGE____ X-LARGE____

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