Each participant must complete a registration form. Registration fee is non-refundable.

runner

cost - early registration
received by Aug. 31/10

cost - registration
received by Sept. 18/10

Adults (18 & over)
$39
$50
Youth (6-17 years old)
$19
$25
Kids (5 & under)
$5
$10
I am participating in:
(please check one)


super early bird draw:
register by July 31st & you're entered to win a one years subscription to Runner's World magazine!

early bird draw:
register by August 31st & you're entered to win an Ipod Shuffle!

first name

last name

address

city

province
postal code

phone (h)

phone (w)

email

age

gender
timothy team member

 

timothy team name

waiver
In checking I AGREE below this release, I (we) understand the intent thereof, and I (we) hereby agree and absolve and hold harmless Gull Lake Baptist Camp Ltd. and Association of Wolf Creek Youth for Christ, corporate sponsors, cooperating organizations and any other parties connected with the Timothy Trek in any way, singly or collectively from and against any blame and liability for any injury misadventure, harm, loss, inconvenience or damage hereby suffered or sustained as a result of participation in the 2010 Timothy Trek, or any activities associated therewith, I (we) hereby consent to and permit emergency treatment in the event of injury or illness. I (we) give full permission to use my name and/or photo in connection with this event.
I Agree

Do you have a medical condition we need to be aware of?
If yes please specify below.

I confirm that the information I have provided is correct.