UNTIL THE DURHAM 1/4 MARATHON -- Saturday, July 24, 2010 @ 9:00 am


REGISTER BY SPONSORSHIP...




You can raise your registration fee through pledges and donations of at least $55. You can do so by either downloading a sponsor/registration form or by directing your sponsors to make a donation in your honour online. Simply direct your sponsors to the following web site www.canadaHelps.org and search for The Refuge Youth Outreach Centre. Once at the main Refuge page, click the button to make a donation and complete the donation information. Make sure your sponsors designate the gift to the Durham 1/4 Marathon and make the gift in your honour. The donation will be applied against your registration fee. Donors will recieve an income tax receipt for the full amount.

Please complete the following form to let us know of your intentions and to ensure that your name and information makes it onto the master registration database.


Name
Mailing Address
City Province PCode
Gender Age on Race Day Shirt Size

I would like to register for the:
1/4 Marathon Run (10.549km)
1/4 Marathon Walk(10.549km)
1/8 Marathon Run (5.27km)
1/8 Marathon Walk (5.27km)

I agree to the RELEASE WAIVER AND INDEMNITY
Please do not send me information about The Refuge


PLEASE NOTE: This form is being sent via e-mail. You may get a message that your e-mail may be exposed. Please continue through the warning and send the form via e-mail. If you do not feel comfortable sending your information in this way please print the form and fax it to 905-404-1910.


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