Register

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Note: Fields marked by a red asterisk (*) are mandatory.

Please indicate which race you want to do *

Advanced: Aug 31 - Sep 2, 2012 *

Classic: Sep 7 - 9, 2012 *

Your Name 1:

Teammate 2:

Teammate 3:

Teammate 4:

Permanent
Mailing Address:

City:

Prov:

Postal Code:

Phone:

Cell :

Email (permanent):

Are you currently
a student?

Yes No

School Attending:

Home Church:

Church Email:

Birthday:
(dd/mm/yyyy)

Gender

M F *

Health Care Provider:

Health Card Number:

Allergies/medical conditions/medicine or special needs:
*

Male T-Shirt Size:

S M L XL XXL

Female T-Shirt Size:

S M L XL XXL *

Emergency contact name:
*

Relationship:

Phone:

Outdoor and/or linguistic training and experience

There is an option of staying at Frontier Lodge after the race, for Sunday night accommodation and having breakfast Monday morning, at the extra cost of $35.70 per person. Please indicate if you would like to do that. *
Yes No

Please keep in mind that by registering for this race, each team is agreeing to fundraise a minimum $2,600 ($650.00/person). Remember that this is just a minimum! Cool prizes will be awarded to the teams and individuals who raise the most amount of money.

Where did you hear about Race to 2025? (check all that apply)

Poster	Newsprint ad	Presented in school
Word of mouth	Brochure	Website link
Presented in church	other:

Have you done the Race to 2025 before? Yes No

PLEASE READ

Wycliffe Bible Translators of Canada Inc abides by Canada’s Personal Information Protection laws. The foregoing information is requested so that we can make adequate race arrangements, and will only be used for this event and subsequent communication. Your signature is required authorizing us to collect, use, and securely retain this information for these Wycliffe purposes. I (we) also give full permission to use my name and/or photo in connection with this event.

In signing this form, I (we) acknowledge that and I (we) hereby agree and absolve and hold harmless the Wycliffe Bible Translators of Canada Inc, corporate sponsors, cooperating organizations and any other parties connected with this event in any way, singly or collectively from and against any blame and liability for any injury, misadventure, harm, loss, inconvenience, death, or damage hereby suffered or sustained as a result or participation in Race to 2025. I (we) hereby consent to and permit emergency treatment from Frontier Lodge staff or their designate in the event of injury or illness.

By typing my name I certify that I am at least 18 years old, or if less than 18 years old, that my parent or guardian has also signed below and that I am the registered participant and acknowledge that I have carefully read this WAIVER AND RELEASE agreement and fully understand and accept its terms.

PARTICIPANT’S Name:

PARENT/ GUARDIAN Name:

PLEASE READ

I hereby acknowledge and agree that in consideration of being permitted to participate in Frontier Camping Society programs, races or activities organized, operated or sanctioned by Frontier Lodge, herein called “the Lodge”:

1) I do hereby release, waive and discharge the Lodge, its members, officers, directors, independent contractors, employees, volunteers and agents, all recourse, proceedings, claims and causes of action of any kind whatsoever, in respect of all personal injuries or property losses which I may suffer arising out of or connected with, my preparation for, or participation in, the aforesaid programs, races or activities EXCEPT where and to the extent such personal injuries or property losses arise out of the negligent acts or omissions of the Lodge, its members, officers, directors, independent contractors, employees, volunteers or agents. This Waiver and Release extends to all claims of every nature or kind whatsoever, foreseen or unforeseen, known or unknown.

2) And, I hereby acknowledge and agree:

a) that wilderness activities and programs are very dangerous, exposing participants to many risks and hazards;

b) that, as a result of the aforesaid risks and hazards, I, as a participant, may suffer serious personal injury, even death, as well as property loss;

c) that some of the aforesaid risks and hazards are foreseeable, but others are not;

d) that I nevertheless freely and voluntarily assume all the aforesaid risks and hazards, and that, accordingly, my preparation for, and participation in the aforesaid programs, races and activities shall be entirely at my own risk;

e) that the Lodge may use photographs or videos that I appear in for promotional purposes;

f) that the Lodge may keep my information on file for a minimum of three years and that my information will be kept confidential and not sold or given to any other organization;

g) that I carefully read the WAIVER AND RELEASE agreement, that I fully understand and accept its terms, and that I am freely and voluntarily executing the same;

h) that this WAIVER AND RELEASE agreement is binding on myself, my heirs, my executors, administrators, personal representatives and assigns.

3) In the event of any injury or illness, I authorize the Lodge staff or their designate to seek and obtain such emergency or medical services as may be deemed necessary at the time.

PARTICIPANT’S Name:

By typing my name I certify that I am the parent or legal guardian of the above-named, under age 18 participant, and acknowledge that I have carefully read this WAIVER AND RELEASE agreement, that I fully understand and accept its terms, that, on the behalf of my child, I am freely and voluntarily executing the same and that I give full permission for the above-named child to participate in all Frontier Lodge program activities and any transportation to and from those activities.

PARENT/ GUARDIAN Name:

An information/fundraising packet will be sent out to each racer upon receipt of registration and payment from each participant. Thank you so much and we look forward to being in contact with you!

CONTACT INFO
Race to 2025 Administrator: Gayle

Phone: 403-250-5411, ext. 257

Other Opportunities for Involvement:

Give instead of going:
See Donate and Sponsor page.