Please enter name and contract phone number of your emergency contact.

I understand that competing in the Elliston Fun Run/Walk event involves running or walking on trails used by other people and traffic and I am aware of the hazards involved. The hazards include but are not limited to: vehicle traffic, actions of competitors, spectators, event personnel, weather conditions and my physical and mental state of health. In my judgement I have sufficient competence and experience to participate safely. I certify that I am physically fit, have sufficiently trained for participation in this event and I have not been advised otherwise by a qualified medical person.