Company / Team Name (optional)
First name *
Last name *
Age *5 (+₵1.00)6 (+₵150.00)7 (+₵150.00)8 (+₵150.00)9 (+₵150.00)10 (+₵150.00)11 (+₵150.00)12 (+₵150.00)13 (+₵150.00)14 (+₵150.00)15 (+₵150.00)16 (+₵150.00)17 (+₵150.00)18 (+₵200.00)19 (+₵200.00)20 (+₵200.00)21 (+₵200.00)22 (+₵200.00)23 (+₵200.00)24 (+₵200.00)25 (+₵200.00)26 (+₵200.00)27 (+₵200.00)28 (+₵200.00)29 (+₵200.00)30 (+₵200.00)31 (+₵200.00)32 (+₵200.00)33 (+₵200.00)34 (+₵200.00)35 (+₵200.00)36 (+₵200.00)37 (+₵200.00)38 (+₵200.00)39 (+₵200.00)40 (+₵200.00)41 (+₵200.00)42 (+₵200.00)43 (+₵200.00)44 (+₵200.00)45 (+₵200.00)46 (+₵200.00)47 (+₵200.00)48 (+₵200.00)49 (+₵200.00)50 (+₵200.00)51 (+₵200.00)52 (+₵200.00)53 (+₵200.00)54 (+₵200.00)55 (+₵200.00)56 (+₵200.00)57 (+₵200.00)58 (+₵200.00)59 (+₵200.00)60 (+₵200.00)61 (+₵200.00)62 (+₵200.00)63 (+₵200.00)64 (+₵200.00)65 (+₵200.00)66 (+₵200.00)67 (+₵200.00)68 (+₵200.00)69 (+₵200.00)70 (+₵200.00)71 (+₵200.00)72 (+₵200.00)73 (+₵200.00)74 (+₵200.00)75 (+₵200.00)76 (+₵200.00)77 (+₵200.00)78 (+₵200.00)79 (+₵200.00)80 (+₵200.00)
Email address *
Phone Number *
Sex *MaleFemale
T-Shirt Size *Youth XSYouth SYouth MYouth LT-shirt size ST-shirt size MT-shirt size LT-shirt size XLT-shirt size XXLT-shirt size XXXL
Select Pickup Location *Max Mart Shopping Centre - Cantoments BranchMax Mart Shopping Centre - Airport Residential BranchChoose Pickup
I have read and understood the terms and conditions below. *
I/We understand that my/our consent to these provisions is given in consideration for being permitted to participate on this event. I/We further understand that I/we may be removed from this event if I/we do not follow all the rules of this event. I am/We are voluntarily participating in this event and I am/we are in good physical condition. I/We know this event can be potentially hazardous and hereby assume all responsibility for the risk of any injury or accident that might occur. Neither I, we, family members, nor associates will file suit against the organizers or sponsors of this event for any injuries or damages any of us might assume during the event or on the premises of the event. This applies to any loss, injury, damage suffered by others or me. This includes falls, contact with fixed or non‐fixed objects, other participants, animals, and risks not known to us or not reasonably foreseeable at this time, or otherwise. Additionally, all photos taken of any of us during the race and during the post‐race activities can be used for Run For a Cure Africa publications. I understand the waiver and release of claims and with my signature give on my behalf and on behalf of all listed above unconditional release of liability to the greatest extent allowed by the law.
Order notes (optional)