OFFICIAL ENTRY FORM Date: __________________

PARTICIPANT/S DETAILS:

Please choose one from the ff:

Kindly specify your: Realty firm or Subdivision/ Condominium or Company name:

Singlet Size

(XS, S, M, L, XL)

BIB NO. (To be filled

out by registration

staff)

Name (Last Name, First Name, Middle Initial)

Birthday (MM/DD/YY)

Sex (M/F)

Contact Number

Email Address

INDIVIDUAL CATEGORY:

1.)

PHI Broker/Agent PHI Homeowner Primary Group of Builders Employee N/A (none of the above)

FOR RELIABLE DUO AND RELIABLE QUAD CATEGORY: (Team Leader)

1.)

PHI Broker/Agent PHI Homeowner Primary Group of Builders Employee N/A (none of the above)

2.)

PHI Broker/Agent PHI Homeowner Primary Group of Builders Employee N/A (none of the above)

3.)

PHI Broker/Agent PHI Homeowner Primary Group of Builders Employee N/A (none of the above)

4.)

PHI Broker/Agent PHI Homeowner Primary Group of Builders Employee N/A (none of the above)

WAIVER In consideration of my/our entry, I/We, my heirs, executor and administrators release and forever discharge the organizers, the servant agent and

subcontractors, all volunteer community groups, and all organization assisting this event; sponsors, producers, their agents and representatives of all liabilities, claims, damages, or cost which I may have against them arising out of or in any way connected with my participation in this event. I understand this waiver includes claims based on negligence, action, or inaction of only the above parties. I fully recognize the difficulty of this event and declare that I am physically fit and able to compete in this event safely and have not been told otherwise by a medically qualified person.

I agree that in the event of race cancellation due to storm, rain, inclement weather, with or any other unforeseeable or “act of God” conditions, my entry fee shall be non-refundable.

I have carefully read and understood the entry guideline and agree to abide by the rules and directions of all race officials on the day of the race.

TO BE FILLED OUT BY REGISTRATION STAFF Date Registered Registration Site Total Registration Fee Receipt Number Name Signature

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- To be filled out by Registration Staff. Present this claim stub together with the payment receipt/any valid ID upon claiming of singlet.

Name of Runner (Individual) or Name of Team Leader (Reliable Duo/Reliable Group Category):

Receipt Number: _____________________

BIB NUMBER(S): ______________________

Bib Number(s): ____________________________________

(To be provided by Registration Staff)

IMPORTANT REMINDERS * Reliable Quad Category shall consist of four (4) runners; Reliable Duo Category shall consist of two (2) runners. Runners will be tied to each other before the start of the run and they must remain tied together until finish.

* The Team Leader for Reliable Quad Category and Reliable Duo Category must be an accredited PHI Broker Agent, PHI Homeowner or Primary Group of Builders Employee.

* Broker/Agent registrants must present a PHI Accreditation ID upon registration to be counted for Largest Contingent.

General Category: Individual Reliable Duo Reliable Quad

Specific Category:

3k 6k 12k Individual Male Individual Male

Individual Male Individual Female Individual Female

Duo Duo

Individual Female

Quad

WAIVER

Name of Participant: Signature:

1.)

2.)

3.)

4.)

IN CASE OF EMERGENCY, CONTACT:

Contact Person: Contact Number:

1.)

2.)

3.)

4.)

SINGLET SIZES: XS S

M

L

XL

Specific Category:

3K Individual Male 6K Individual Male 12K Individual Male

3K Individual Female 6K Individual Female

3K Duo 6K Duo

12K Individual Female

3K Quad

CLAIM STUB