SAVE GEORGIA STRAIT ALLIANCE
2nd Floor, 479 4th Street, Courtenay, B.C. VON 1G9

The registration fee for participating in the marathon is $20 per individual, or $10 per team and $10 per team
member. Each participant will receive a t-shirt anc each team a fiag. Please indicate your t-shirt size:
small medium large x-large

Please fill out both sides of this form and mail to SGSA soon. For information, phone:
Nanaimo:753-5212 or 247-8670/ Sechelt: 885-9473 or 885-5997/ Victoria: 383-9726
Comox Valley: 338-9242/ Vancouver: 253-7701/ Ladysmith: 2.45-2580/ Salt Spring: 537-4882

VOLUNTEER (always appreciated)

Detailed information mailed out with confirmation. NAME
Mail completed entry forms and cheques to:

ADDRESS

Save Georgia Strait Alliance,
2nd Floor, 479 Fourth Street CITY
Courtenay B.C. VON 1G9
(604) 338-9242 PHONE

ESCORT BOAT

Deadline for registration: July 31. a
Late registrations accepted only if there is room. Add $10. ||SIZE-

#PASSENGERS

READ CAREFULLY BEFORE SIGNING

1 acknowledge that a Marathon {s an extreme test of a person's physical and mental limits and carries with it the potentiai
for death, serious injury and property loss. 1 HEREBY ASSUME THE RISKS OF PARTICIPATING IN MARATHONS. I
certify that | am physically fit, have sufficiently trained for participation in this event(s). and have not been advised other-
wise by a qualified medical person. I hereby take action for myself, my executors, administrators, heirs, next of kin,
successors and assigns as follows: a) WAIVE, RELEASE, DISCHARGE AND AGREE NOT TO SUE from any and all Hability
for my death, disability, personal injury, property damage, property theft or action of any kind which may hereafter accrue
to me as a result of my participation in, or my travelling to and from THE FOLLOWING ENTITIES: Save the Strait
Marathon, Event sponsors, Event producers, Event workers and volunteers, Event connected charities, and all citics,
countries, districts, public agencies and/or provinces in which said Events may be staged or in which segments of said
Events may be run or have responsibility therefore and the officers, directors, employees, representat. “3 and agents and
volunteers of all of the above.

b) INDEMNIFY AND HOLD HARMLESS the persons or entitles mentioned in this paragraph from any of my actions during
an Event. This waiver release and indemnification agreement is not Intended to encompass claims arising out of inten-
tional misconduct by the covered parties. | acknowledge that the above Waiver and Release applies specifically to the
Save the Strait Marathon and to all persons and entities associated with it. I hereby consent to receive medical treat-
ment in the event of my injury, acciden: 2.ad/or illness, during any event. I understand that at SAVE GEORGIA STRAIT
ALLIANCE (SGSA) Events or related activities, | may be photographed. I agree to allowing my photo, video or film
likeness to be used for any legitimate purpose by SGSA, the Event producer(s), Event Sponsors and/or assigns. | hereby
consent that | am nineteen (19) years of age, or older, I have read this document, and 1 UNDERSTAND THE CONTENTS.

Signature aineot paneer puardian if under 19