Indemnity Form - Winston Farms

WINSTON WHIP TRAIL RUN, 10km & 5km WALK/RUN

Name*

First Last

ID Number*

Email*

Cell Phone*

Medical Aid Name and Number*

Emergency Contact – please make sure this person is not involved with the same event as you are & that they are contactable on the day

Emergency Contact Name*

First Last

Emergency Contact Phone*

Event*

I, the undersigned competitor, do hereby specifically indemnify the race organisers, agents, sponsors, owners of land and all other parties associated with the above event against any and all damages, injuries or any loss of whatever kind that I may sustain or suffer as a result of my participation in the above event. I accept that any costs incurred as a result of medical treatment and/or emergency evacuation, as deemed necessary by the race organisers, are to be borne by myself or my insurer. I accept that the race may be cancelled or shortened due to adverse weather conditions and, in such an event, I am not entitled to a refund or rebate of the race fee. Should the race organisers decide that I should drop out of the race or follow a shortened course due to health, safety or time factors, I agree to abide by their decision. I am aware that there are many water features such as dams, dips, pools and rivers on the farm and if they are approached I do so at my own risk.

This field is hidden when viewing the form

Parent / Gaurdian*

Is entrant under the age of 18?

Is entrant under the age of 18?*

Name of Parent / Guardian*

First Last

Id of Parent / Guardian*

14 – 16 October 2022 | Winston Farm, Hogsback

14 – 16 October 2022
Winston Farm, Hogsback

Enter Now

Enjoy hidden gems of the Eastern Cape’s Amahlathi area