Registration Form

ONLINE REGISTRATION FOR DELIVERY WITHIN METRO MANILA ONLY
(15 April – 15 May, 2011)
a. Pay thru bank
Bank/ Branch : BDO/SM Megamall B
Account No : 2804-71025
Account Name : RSH Marketing Phils, Inc.
Amount : Entry Fee + P100 Delivery Charge
b. Race Kits will be delivered on or before 31 May 2011
This event will use the Runningmate Timing System. Please fill up this form completely so you may receive the race results through text and email. Thank you.
Payment Date* :
   
Reference Code* :
   
Singlet:
   
Category:  5K 10K 15K
   
Gender:  Male Female
First Name:

MI:

Last Name:

Date of Birth (M/D/Y) :

Company/ Group/ Organization:

Position:
Mailing Address:

Telephone Number:

Mobile Number:

Fax Number:

Email Address:


WAIVER/ RELEASE AGREEMENT

I have read the registration details completely and understand the rules and regulations of the event. I should not participate unless I am medically able. I understand the nature of, and assume all risks associated with my voluntary participation in this event. I therefore release, remise and forever discharge RSH Marketing Philippines, its subsidiaries and affiliates (“Related Entities”) and their respective stockholders, directors, officers, employees and representatives from any and all claims, demands, liabilities, actions, causes of actions, lawsuits or equity of whatsoever kind and nature, whether known or unknown, relating to, arising out of, or in connection with my participation this event.
Furthermore, I hereby certify/declare that all information in my Registration Form is true and correct. Participants below 18 years old must have their entry form signed by a Guardian

Do you agree with the waiver?:  Yes No

OVER THE COUNTER REGISTRATION
(1 – 31 May 2011 or once all slots have been filled up, whichever comes first)
a. Reebok Eastwood
b. Royal Sporting House, Ali Mall, Cubao
c. Reebok, Megamall, Ortigas
d. Shoe Shop, Power Plant Mall, Rockwell
e. Royal Sporting House, Robinson’s Place, Ermita
f. Shoe Shop, Alabang Town Center, Muntinlupa
g. Reebok, Festival Mall, Alabang, Muntinlupa