5K

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RATE: P500
Inclusive of New Balance
Running Shirt*, and Timing Chip
Deadline: Dec. 22, 2010
FILL UP FORM
First Name Gender
LIABILITY WAIVER AND RACE AGREEMENT:
Last Name M F

In the consideration of your acceptance of my entry, I, intending to be

Email Address
legally bound, do hereby for myself,my heirs,executor,and administrators,

Address Number and Street waive and release forever any and all rights to claims or damages I
may have against the event organizers, sponsors, volunteers, race
City officials, the City of Cebu and all parties involved. I affirm to be physically
fit and able to participate and have full knowledge of the risks
Province involved. I also give my permission for the free use of my name (s),
photo and /or voice in any broadcast, telecast, print account or any
State
other account in any medium of this event.

Country Postal Code

_________________________ ______________________
Signature over printed name Date of registration

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Nationality

Date of Birth (MM/DD/YR) Age

Telephone Number
PAY AT:
Mobile Number • Cebu: Ayala Active Zone
• Manila: Planet Sports, 2nd Level Powerplant Mall Rockwell Center,
Occupation Makati City (632) 756-5007
• Other Vis-Min cities:
- Planet Sports Cagayan de Oro City - Level 1 North Concourse
Company/School Limketkai Mall (088) 856-6881
- The Athlete’s Foot Bacolod - Ground Floor Robinson's Place Lacson
Shirt Size S M L XL XXL St. Mandalagan (034) 4410543
- The Athlete’s Foot Dumaguete - Level 1 Robinsons Mall, Calindagan

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5K
PRESENT THIS STUB & O.R. TO CLAIM YOUR RACE PACKET
• Claim your race packs during the Marathon Expo from Jan. 05 - 07, 2011 at Active Zone, Ayala Center Cebu
• *Only the first 4,500 Registrants will get a Running Shirt. Size depends on supply availability.
• For more inquiries visit our website: www.cebumarathon.com
NAME: ____________________________________________________________________________________

RECEIVED BY:_______________________________ DATE:_____________

PRESENTED BY:

ORGANIZED BY: