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Zinkwazi Classic 2023 - Entry Form
Name:*
Phone:*
Email:*
Province
Date of Birth:

Category
Race Options

10KM RACE - SUP: Entry R250
 
10KM RACE - Prone: Entry R250
 
5KM SOCIAL RACE: Entry R150
 
Includes SUPSA Fee.
 
EFT payment to: SUP Durbs!, FNB Acc 62586675814, Branch Code 221126. Use name as reference and email POP to jon@jonivins.com

INDEMNITY: In checking the box below, I agree that I am familiar with and fully understand all risks and hazards that exist in connection with the Zinkwazi Classic 2023. I further state that I hereby assume the risk and costs for any injuries and/or disabilities that I may sustain during my entry to the Zinkwazi Classic 2023. I hereby fully release and forever discharge the Zinkwazi Classic 2023, SUP Durbs! Club, its officials, members, affiliates and sponsors that may result from any type of injury, disability or death, that I may sustain while participating in and/or attending and traveling to or from the Zinkwazi Classic 2023 event. In signing below I also agree to abide by the constitution of SUPSA. These are available on our website: http://www.supdurbs.co.za/pages/13416/supsa

Signed by checking box Agree
Security Code* What is 8 plus 7

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