SlideShare a Scribd company logo
ENQUIRIES: Diabetes SA 084 717 7443 OR Nerve Events 031 201 2169
PRE-ENTRY
You may Pre-Enter at the Diabetes SA office, Mon to Fri 9h00 to 15h00,
and Sat 21st
, Sun 22nd
& Sat 28th
November 9h00 to 15h00.
www.diabetessa.org.za
Take steps to prevent
Diabetes by entering the
LuckyDrawPrizes!
Please email durban@diabetessa.org.za for an entry form or collect at the Diabetes SA Office.
Diabetes SA: Office 62, 1st Floor, Davenport Square cnr Brand & Clark Rds, Glenwood.
This event is supported by the South African Sugar Association
AMPHITHEATRE | BAY OF PLENTY
29 Nov 2015 | 8am | Entry: R50
5km Walk & Wellness Expo
Full Name:..................................................................................................... Age:.................................
Email:............................................................................................................. Tel: ...................................
Cell:............................................................................... Male Female
Have you been diagnosed with Diabetes? Yes No
If yes, are you Type 1 Type 2
ENTRY FORM
This event is supported by the South African Sugar Association
WAIVER/INDEMNITY
I (Name).................................................
................................................................,
hereby declare that I take full
responsibility concerning any
injuries that could happen to
me during this event. Under no
circumstances will I hold the
eThekwini Municipality, Sponsors
and Organisers responsible in the
case of an accident to my person,
and therefore will not take action
against them at any time and any
place. Knowing these facts I take
the decision on my own to enter the
Global Diabetes Walk.
Also, in order to let Nerve Events
promote this event, I allow Nerve
Events to use my image and speech
being recorded during the build up,
on the day and post event.
I acknowledge that I have read and
understood this waiver.
I fully accept all the facts mentioned
above by signing this waiver down
below.
Signature:.......................................
(or Signature of legal guardian for minors)
Date:................................................
Please email durban@diabetessa.org.za for an
entry form or collect at the Diabetes SA Office
RULES
1. Race starts at 08h00 and cut off time is 10h00.
2. Marshalls & officials must be obeyed at all times.
3. Participants are responsible for their own safety.
4. NO LITTERING! Cups and sachets to be thrown away in
bins provided on route.
5. Only paid entries received by hand, email or fax will be
entered into the lucky draws.
6. Prize Giving / Lucky Draw - will take place at 10h15.
Only registered walkers are eligible for prizes and
winners must be present in order to win and receive
their prize.
GENERAL INFORMATION
Late Entries: Cash only entries will be received on the
day of the event from 07h00 to 07h45. Arrive early to avoid
queuing.
On Race Day: There will be two water points on route.
Please bring your own water bottle as well.
EXPO: The Wellness Expo will include FREE testing stations
for blood glucose, blood pressure, eye testing, kidney
function testing and foot screening.
Please bring cash on the day, no credit card facilities.
Well known Health Expert Lisa Raleigh will once again be
our MC.
Dress: Casual sportswear and comfortable walking shoes.
Parking: Free parking available on the beach front.
BANKING DETAILS:
Diabetes SA Fundraising Account
ABSA • Branch Code: 632005
Acc No.: 4078661612
Please email proof of payment
and completed entry form to
durban@diabetessa.org.za

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Diabetes South Africa – Global Walk

  • 1. ENQUIRIES: Diabetes SA 084 717 7443 OR Nerve Events 031 201 2169 PRE-ENTRY You may Pre-Enter at the Diabetes SA office, Mon to Fri 9h00 to 15h00, and Sat 21st , Sun 22nd & Sat 28th November 9h00 to 15h00. www.diabetessa.org.za Take steps to prevent Diabetes by entering the LuckyDrawPrizes! Please email durban@diabetessa.org.za for an entry form or collect at the Diabetes SA Office. Diabetes SA: Office 62, 1st Floor, Davenport Square cnr Brand & Clark Rds, Glenwood. This event is supported by the South African Sugar Association AMPHITHEATRE | BAY OF PLENTY 29 Nov 2015 | 8am | Entry: R50 5km Walk & Wellness Expo
  • 2. Full Name:..................................................................................................... Age:................................. Email:............................................................................................................. Tel: ................................... Cell:............................................................................... Male Female Have you been diagnosed with Diabetes? Yes No If yes, are you Type 1 Type 2 ENTRY FORM This event is supported by the South African Sugar Association WAIVER/INDEMNITY I (Name)................................................. ................................................................, hereby declare that I take full responsibility concerning any injuries that could happen to me during this event. Under no circumstances will I hold the eThekwini Municipality, Sponsors and Organisers responsible in the case of an accident to my person, and therefore will not take action against them at any time and any place. Knowing these facts I take the decision on my own to enter the Global Diabetes Walk. Also, in order to let Nerve Events promote this event, I allow Nerve Events to use my image and speech being recorded during the build up, on the day and post event. I acknowledge that I have read and understood this waiver. I fully accept all the facts mentioned above by signing this waiver down below. Signature:....................................... (or Signature of legal guardian for minors) Date:................................................ Please email durban@diabetessa.org.za for an entry form or collect at the Diabetes SA Office RULES 1. Race starts at 08h00 and cut off time is 10h00. 2. Marshalls & officials must be obeyed at all times. 3. Participants are responsible for their own safety. 4. NO LITTERING! Cups and sachets to be thrown away in bins provided on route. 5. Only paid entries received by hand, email or fax will be entered into the lucky draws. 6. Prize Giving / Lucky Draw - will take place at 10h15. Only registered walkers are eligible for prizes and winners must be present in order to win and receive their prize. GENERAL INFORMATION Late Entries: Cash only entries will be received on the day of the event from 07h00 to 07h45. Arrive early to avoid queuing. On Race Day: There will be two water points on route. Please bring your own water bottle as well. EXPO: The Wellness Expo will include FREE testing stations for blood glucose, blood pressure, eye testing, kidney function testing and foot screening. Please bring cash on the day, no credit card facilities. Well known Health Expert Lisa Raleigh will once again be our MC. Dress: Casual sportswear and comfortable walking shoes. Parking: Free parking available on the beach front. BANKING DETAILS: Diabetes SA Fundraising Account ABSA • Branch Code: 632005 Acc No.: 4078661612 Please email proof of payment and completed entry form to durban@diabetessa.org.za