SAGE STOMP XVIII ENTRY FORM
Please mail entries to Gill Bailey,
Sage Stomp XVIII, 4337 San Cristo Place, Victoria V8N 5G5. Cheques and money orders should be in
Canadian Dollars and payable to OABC.
Please be sure and sign the Waiver.
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Contact Name |
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Contact Address |
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Telephone |
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E-mail Address |
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Comp. # (Official
use only) |
Name
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Club
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Year of Birth
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Class
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SPORTident
#
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Split
Starts |
WCOC Day 1 $20/10 |
WCOC Day 2 $20/10 |
HP
Fund
$20/10 |
Relay
15/10 |
COC
Short $20/10 |
COC
Day
1 $20/10 |
COC
Day 2 $20/10 |
COC
Eligible
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Entry
Fees |
Example |
Joe Blow |
GVOC |
1945 |
M45 |
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No |
20 |
20 |
20 |
No |
20 |
20 |
20 |
Yes |
120.00 |
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Please note that after 31/5/03 entry fees rise to $25 and $12.50, for all events except the Relay, which rises to $20 and $12.50, and that entries close 25/7/03. Competitors who are not members of their national federation should add $5/day for seniors, $2.50/day for juniors.
Competitor Entry Fees
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SPORTident Hire @ $2.00/day/competitor or $10 for
all events |
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T shirts:
No. @ $18/shirt:
, see below to note sizes |
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Model Event Maps: No. @ $5: |
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Additional betting vouchers for the Showcase: @ $10 each |
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Results @ $5/set (incl postage) |
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Banquet, August 16th, No. of Adults @
$20: , No. of Children @ $10: |
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Banquet, August 23rd, No. of Adults @
$20: , No. of Children @ $10: |
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Donation
to the Canadian National Team: |
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TOTAL FEES |
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SPLIT STARTS: Early competitor :_______________________, Late competitor:_______________________
T SHIRTS: No. of XS: ___, S:___, M:____, L:___, XL:___
RELAY
Team
Name
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Club |
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Province |
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Country |
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Points |
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Class, A, B or C |
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Leg 1 (intermediate) |
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Leg 2 (novice) |
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Leg 3 (advanced) |
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WAIVER
All participants must sign the following waiver
before starting any event.
I, the applicant, on behalf of my family, my heirs, executors,
administrators and assigns, recognizing that orienteering is a hazardous sport,
hereby forever discharge and hold harmless the Greater Vancouver Orienteering
Club, the Sage Orienteering Club, the Victorienteers, the Williams Lake
Orienteering Club, the Orienteering Association of British Columbia, the
Canadian Orienteering Federation, their representatives and agents and any and
all persons who own or occupy land, which may be used for these events, for any
injury, loss or damage to my person or property, howsoever caused, arising out
of or in connection with my taking part in the events which I am entering.
Name:
_________________________________
Signature: ______________________________
Name:
_________________________________
Signature: ______________________________
Name:
_________________________________
Signature: ______________________________
Name:
_________________________________
Signature: ______________________________
Name:
_________________________________
Signature: ______________________________
A parent
or guardian must sign for any participant under the age of 18.