Address (inc post code) * Phone * Email * Driver's Age (if under 18) 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years 17 years IFSS (DID) Number (if applicable) 2019 Race Class & Entry Fee (select all applicable):
**The discounted $40.00 4 Dog Rig fee is ONLY applicable for the same musher competing with two rig teams, the first team being in Heat #1 paying the full price of $50.00. All other teams (including those sharing equipment) will pay the full $50.00 fee regardless of being in Heat #1 or Heat #2. A team may also be moved between Heat #1 and Heat #2 at the discretion of the RGO. Heat #1 and #2 entrants will be confirmed at the Musher Meeting.
RNB/PB: Registered Northern Breed/Purebred class pertains to the registered Siberian Husky, Alaskan Malamute, Samoyed, Greenland Dog or Inuit Dog.
Kid & Mutt age of child: 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years Mushers' Banquet Tickets $20.00 each (optional) * None required 1 ticket - regular meal ($20.00) 2 tickets - regular meal ($40.00) 3 tickets - regular meal ($60.00) 4 tickets - regular meal ($80.00) Mushers' Banquet Tickets - Vegetarian $20.00 each (optional) * None required 1 ticket - vegetarian meal ($20.00) 2 tickets - vegetarian meal ($40.00) 3 tickets - vegetarian meal ($60.00) 4 tickets - vegetarian meal ($80.00) Rustic Group Camping - Deposit ($15.00) per person (optional) * None required 1 person ($15.00) 2 people ($30.00) 3 people ($45.00) 4 people ($60.00) 5 people ($75.00) 6 people ($90.00)
Please note: if camping is booked, due to the Park's fees for the sites required in advance, the deposit is non-refundable.
I will be making payment by: *
Please add your Team Driver Name in the 'Message' section of the e-transfer. No password is required for banks that allow auto-deposits.
I agree to be responsible for my conduct, my dogs and handlers and to abide by all decisions of the Race Officials, which are final. I shall not hold the sponsors/organisation/individuals/Parks Ontario/private land owners liable for any injury/accident, which may occur during or as a result of the race. I give permission for the free use of my name, voice, video or picture in any broadcast, advertising promotion or account of this event. It is required that all participants are insured/carry some form of a PIP personal injury/insurance protection plan/policy or Personal Accident protection thought their insurance company or legal guardians plan, or have accident/injury coverage through a secondary provider/benefits plan. Please check with your insurance broker/company that you have suitable cover.
Electronic Signature - printing your name here will be regarded as your signature in agreeing to the terms and conditions. *
I, for myself, my heirs, executors, administrators, successors and assigns HEREBY RELEASE, WAIVE AND FOREVER
DISCHARGE The Corporation/SSASO, MacGregor Point Provincial Park, Parks Ontario of the Town of Port Elgin,
Municipality of Saugeen Shores and all other officials, property owners, volunteers, servants, contractors,
representatives, sponsors, successors and assigns OF AND FROM ALL claims, demands, damages, costs, expenses,
actions and causes of action, whether in law or equity, in respect of death, injury, loss or damage to my person or
property HOWSOEVER CAUSED, arising or to arise by reason of my participation in the said event, whether as
spectator, participant, competitor, volunteer or otherwise; whether prior to, during or subsequent to the event AND
NOTWITHSTANDING that same may have been contributed to or occasioned by the negligence of any of the
I FURTHER HEREBY UNDERTAKE to HOLD AND SAVE HARMLESS and AGREE TO INDEMNIFY all of the aforesaid from and
against any and all liability incurred by any or all of them arising as a result of, or in any way connected with my
participation in the said event.
BY SUBMITTING this ENTRY, I ACKNOWLEDGE HAVING READ, UNDERSTOOD AND AGREED to the above WAIVER,
RELEASE, and INDEMNITY.
By SIGNING this document I understand that, no claims can be made to any
of the entities listed on the insurance policy, or this waiver for their participation in the MacGregor Point Dryland
Sled Dog Derby. I state that I am of sound body and mind, physically fit and fully aware of the risks associated to
myself, others, animals and equipment in competing in competitive harness based sled dog races.