6-7 March 2021 Wilderness, WESTERN CAPE Payment OptionFull PaymentPayment plan (3 x installments)FULL PAYMENT or PAYMENT PLAN No refunds on 1st payment if Payment Plan is selectedFULL PAYMENT*Entry + Sharing Accommodation R3,450.00Entry + Single Accommodation R3,700.00Entry + Meals only R3,000.00Choose between SHARING and SINGLE accommodationPAYMENT PLAN*Entry + Sharing Accommodation R3,450.00Entry + Single Accommodation R3,700.00Entry + Meals only R3,000.00Choose between SINGLE or SHARING accommodationTrail Girl Funky PantsNo Thank YouSmall R450Medium R450Large R450XLarge R450The most amazing running shorts made by Funky Pants!Trail Girl Funky PantsNo Thank YouSmall R450Medium R450Large R450XLarge R450The most amazing running shorts made by Funky Pants!Total R0.00 Name* First Last ID Number*Category (age at the time of the race)*Open (39 years and younger)Vet (40-49 years)Master (50 years and older)Date of Birth* Date Format: MM slash DD slash YYYY Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country If Sharing accommodation, who are you sharing with?Please give name of your friend you want to share withT-Shirt Size - make sure of your size! See Below*SmallMediumLargeX-LargeXX-LargeSize Chest Under arm (measure all around) XXS-73cm, XS-78cm, S- 83cm, M-88cm, L-93cm, XL-100cm, XXL-108cm, Special Meal Requirements*Medical Aid Name and Number*Emergency Contact Person*Emergency Phone Number*Where did you hear about the race?*How many Trail Girl events have you participated in?*Would your company be interested in getting on board as a Sponsor for example sponsoring the water tables?*Indemnity* I agree By agreeing, I hereby waive any claim which can be made against the shareholders, directors and staff of Trisport SA, Fairy Knowe Hotel, or temporarily staff on the event or any private lodge, home owner or farm owner, or any sponsor associated with the event(Hereinafter referred as the INDEMNIFIED PERSONS), which may arise from any activities offered by the INDEMNIFIED PERSONS and specifically with regard to this Event. The INDEMNITY GRANTOR hereby releases the INDEMNIFIED PERSONS from all liability and holds each and all the INDEMNIFIED PERSONS harmless against all claims, damages, injuries, losses, debts, expenses and liabilities arising out of or in any way connected with any activities offered by the INDEMNIFIED PERSONS, including without limitation: 1. Any personal injury or loss of life; 2. Any loss of support, maintenance or other claims or damages arising from or connected with any personal injury or loss of life to the INDEMNITY GRANTOR; and 3. Any loss or damage to property belonging to the INDEMNITY GRANTOR or any third party, which may occur whilst participating in the said race; 4. Whether arising out of strict liability, statute or otherwise and whether caused by the negligence on the part of the INDEMNIFIED PERSONS or any other person or otherwise I am fully aware of the dangers associated with this event and of the dangers to which we will expose myself during the event. I am fully aware of the possibility of human interference other than that of the organizers and the INDEMNITY GRANTOR fully accepts all the risks associated therewith. I acknowledge that I am aware that trail running and mountain biking are dangerous activities on off-road terrain and there are significant risks involved which can lead to severe trauma, injury and loss of life. I further acknowledge that the race may be stopped on the organisers discretion if the conditions become too dangerous in their opinion. I hereby undertake to always follow their instructions and I accept that failure to do so on my part will expose me to potential severe injuries or loss of life. During the event, children should always be under parent supervision IMDENNIFIED PERSONS will be indemnified and held harmless against all claims, damages, injuries, losses, debts, expenses and liabilities arising out of or in any way connected with any children activities offered by the INDEMNIFIED PERSONS. I declare that I am physically fit and healthy so far as may reasonably be determined and undertake to inform the organizers and their team of any condition, medical or otherwise past and/or present, which may have an impact on my participation and the participation of others in the aforesaid activities. Each clause of this Deed of Indemnity is independent and severable from all other clauses. The acknowledgements, agreements and undertakings in this indemnity shall be deemed to be made in favour of the INDEMNIFIED PERSONS. Each element of the release from liability and/or indemnity in respect of each cause or activity covered by this release from liability and/or indemnity shall be separate and severable from the other elements. This indemnity shall in all respect be governed by the Laws of the Republic of South Africa, and all disputes actions and other matters arising in connection herewith, shall be determined in accordance with such laws. Total R0.00 PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.