RM 60 EARLY BIRD RM 70 NORMAL FEE RM 90 LATE FEE RM 50 STUDENT

CATEGORYMEN'S OPEN (18 & ABOVE) WOMEN'S OPEN (18 & ABOVE)

BOY'S OPEN (17 & BELOW) GIRL'S OPEN (17 & BELOW)

NAME

I/C, PASSPORT

DATE OF BIRTH D D M M Y Y Y Y AGE T‐SHIRT SIZE XS S M L XL

GENDER MALE FEMALE

NATIONALITY

ADDRESS

EMAIL

PHONE NUMBER

EMERGANCY CONTACT NAME

EMERGANCY CONTACT

PARENT/GUARDIAN SIGNATURE (MINOR) SIGNATURE (ADULT)

To be submi�ed at: WILD BORNEO, Ground floor, Likas golf Driving Range, Jalan Is�adat, 88400 Kota Kinabalu, Sabah +6012 801 1979

RECEIPT NO: ORDER NO

50 60 70 90

OFFICIAL ENTRY FORM

OFFICE USE

*T‐Shirt Size Upon Availability

I know that running is a poten�ally hazardous ac�vity. I should not enter and run unless I am medically able and properly t rained. I agree to abide by any decision of a race official rela�ve to my ability to safely complete the run. I hereby cer�fy that I am in good health and I have trained to run the distance of the race, which I am entering. I assume all risks associated with running in this event i ncluding, but not limited to: falls, contact with other par�cipants, the effects of weather, including high heat and/or humidity, traffic and the condi�ons of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in considerat ion of your accep�ng my entry into this running race, I, for myself and anyone en�tled to act on my behalf, waive and release the World Animal Day Wild Run 2016, its officers, directors, agents, volunteers and employees, all states, ci�es, coun�es, or other governmental bodies or loca�ons in which events or segments of events are held, all sponsors, their representa�ves and successors, from all claims or liabili�es of any kind arising out of my par�cipa�on in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, mo�on pictures, recordings, or any other record of this e vent for any legi�mate purpose. I understand that bicycles, skateboards, roller skates or inline skates and I will abide by this policy. I also understand that baby joggers are discouraged for the safety of all par�cipants. I am aware that the organizer strongly discourages the use of personal audio devices (Handphone, iPods & MP3 headsets). I authorize any healthcare provider to release any and all informa�on pertaining to my healthcare, medical condi�on and medical treatment as a result of my par�cipa�on in this World Animal Day Wild Run 2016 event to the World Animal Day Wild Run 2015 and its staff.This Waiver and Release Form shall be governed by the laws of Malaysia. I cer�fy I am 18 years of age or older and the infor mation set forth is true and complete.

In considera�on of your minor child being permi�ed to par�cipate in the World Animal Day Wild Run 2016 you hereby a�est that, a�er reading this Waiver and Release Form completely and carefully, you acknowledge that par�cipa�on in the World Animal Day Wild Run 2016 by your child is en�rely voluntary, and that you understand and agree as the following above

WORLD ANIMAL DAY:

WILD RUN 2016SUNDAY, 9 OCTOBER 2016 6.00AM

WAIVER