Raving the Vine
D’Angelo Estate Winery
Amherstburg, Ontario
Saturday Sept. 25, 2010
Race Time: 5pm
Festivities: 6pm
ONLINE REGISTRATION


Online registration will close at 8 pm. Thursday Sep. 23, 2010

Registration Instructions

  1. Enter the required information below.
  2. Confirm the information you entered and get total to be charged.
  3. Enter your credit card information.
  4. Transaction is processed and a receipt is emailed to the address you supplied.
  5. Check the online confirmation list. If there are any questions about your online registration please contact us at racingthevine@onlineregistrations.ca, for all event related questions (including questions about your mailed in registration) Please contact Kim at (519)254-5577 ext. 52458 for further details.(Event Website)
All fees non-refundable and non-transferable.
Required information is marked with a red asterisk (*).
Registration Fees

 

* Choose your event Event
Entry Fee
(on or before Sept 16)
Entry Fee
(after Sept 16)
5km run
$27
$35
5km walk
$27
$35
Grape Dash
$10
$10

First 500 registrants receive a special gift.

* A transaction fee will be applied. 
Athlete Details
*First Name:
*Last Name:
*Email Address: (we will send your receipt to this address)
*Phone (+ area code): ( )-
*Gender: female        male
*Date of birth:
*Age on Race Day:
*Street:
*City:
*Prov./State:
*Postal/Zip Code:
Release Waiver and Indemnity

In consideration of your acceptance of this entry, I, for myself, my heirs, executors, administrators and assigns, hereby waive, release and discharge any and all claims against Windsor Regional Hospital Foundation, Racing the Vine, event sponsors, event volunteers and their officers, directors, agents, successors, and/or assigns for any and all injuries suffered by me at this event. I attest that I am physically fit and sufficiently trained for competition in this event. I hereby grant permission for the free use of my name, and picture in any broadcast, brochure, or account of this program.

I ATTEST AND VERIFY THAT I AM 18 YEARS OF AGE OR THAT I AM SIGNING AS THE LEGAL GUARDIAN ON BEHALF OF AN EVENT PARTICIPANT UNDER THE AGE OF 18 YEARS.

Agreeing to this waiver and registering online for this event by me, for myself or as legal guardian of an event participant, in an electronic format authorizes you to accept this waiver as signed by me.

I have read and agree to the waiver.

Parents name if under 18 years of age


OR