Clone of 2012 Canadian Death Race

2012 Canadian Death Race - Team Registration (Sample Form) ** OLD

You can look at this form to get an idea of what info you will need to complete the actual team registration form (which will be available after registration opens)
TeamName
Make sure of your Team Name. No changes will be allowed under any circumstances. Keep it clean; this is a family event!
Team Captain
CaptainName

First NameLast Name
Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
HomePhone
WorkPhone
CellPhone
Team Members

Names

Please enter each racers age category on race day

Rows	Leg1	Leg2	Leg3	Leg4	Leg5
AgeCategory

Rows	Leg1	Leg2	Leg3	Leg4	Leg5
Gender

Rows	Leg1	Leg2	Leg3	Leg4	Leg5
TShirt

ContactInfo

Prior Races Attended

Leg1 Biography
200 character limit
Leg2 Biography
200 character limit
Leg3 Biography
200 character limit
Leg4 Biography
200 character limit
Leg5 Biography
200 character limit
Is there a significant medical problem that the racer would like us to know about? (If you select "yes" to any of these, an additional field will appear where you can describe the problem.)
Leg1 Medical
Leg2 Medical
Leg3 Medical
Leg4 Medical
Leg5 Medical
Leg1 MedicalProb
Please describe the issue here. 200 character limit.
Leg2 MedicalProb
Please describe the issue here. 200 character limit.
Leg3 MedicalProb
Please describe the issue here. 200 character limit.
Leg4 MedicalProb
Please describe the issue here. 200 character limit.
Leg5 MedicalProb
Please describe the issue here. 200 character limit.
Consent

I, as the Team Captain, agree to all the risks of participating in the race, up to and including death and that I and my team-mates have read and agree to the Waiver of Laibility (www.canadiandeathrace.com/waiver). I also understand that there are no refunds. AS TEAM CAPTAIN, I (or delegate) MUST BRING MY ENTIRE TEAM'S SIGNED WAIVERS WITH ME FRIDAY OF RACE DAY WEEKEND TO PICK UP OUR TEAM RACE KIT.
On the real registration form, there will be a "Submit" button here . Once you submit this form you will be directed to pay through Paypal. The team registration fee is $1750 and 5% GST will be added to your purchase.
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2012 Canadian Death Race - Team Registration (Sample Form) ** OLD