Tough Bugga 2017 Online Entry Form Tough Bugga 2017 Race Entry Fields with * are required. Event: * ---Tough Bugga 3kmTough Bugga 5kmTough Bugga 10km Team name * Team captain Name * Gender * MaleFemale Phone * Email * Emergency Contact Person Name * Emergency Contact Person Phone * Your Team * Team Member Name Email Phone No. Age Bracket 1 ---Under 13 yrs13 yrs and over 2 ---Under 13 yrs13 yrs and over 3 ---Under 13 yrs13 yrs and over 4 ---Under 13 yrs13 yrs and over 5 ---Under 13 yrs13 yrs and over 6 ---Under 13 yrs13 yrs and over 7 ---Under 13 yrs13 yrs and over 8 ---Under 13 yrs13 yrs and over 9 ---Under 13 yrs13 yrs and over 10 ---Under 13 yrs13 yrs and over Entry Fees: $10 Per Competitor - Children under 13 years $20 Per Competitor - Adults and 13+ years $45 Per Family - 2 Adults & 2 Children. (For each extra person add the per competitor fee above) Total: Direct credit payment to: ASB 12-3253-0083303-51, make your TEAM NAME the reference. We will send you an email when your payment has been received. Team Waiver and Disclaimer We agree to enter this event at our own risk and also accept that this race involves risks and will not hold event organisers, officials, sponsors or any person involved in this event liable for any loss or injury to equipment or person incurred during the event. We have read and understood the event rules and will abide by the decision of the Race Directors in any and all matters. We hereby allow the use of our name and pictures to be used in the media and for marketing purposes. *By ticking this box I agree with the race rules and the waiver above. By checking this box I agree to print and sign the waiver for under 18 year olds in case it applies and present it on race day. (form below) Under aged waiver Where are you from? Where did you hear about us?