Support The Gingerbread Guild by signing the petition The indoor rowing challenge for children's literacy Registration Form To send the information, click on the submit button at the bottom of this page. You may also fill in the form and send it to : The Gingerbread Guild PO BOX 1547 St Jean de Matha, Qc J0K 2S0 or Club Sportif MAA 2070 rue Peel Montreal, Qc H3A 1W6 Name (first, last)   Address   City   Province   Postal code   Tel. (day)   Tel. (evening)   Email   Date of birth   mm January February March April May June July August September October November December   dd 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31  ,  yyyy 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Age on race day (on Nov. 9, 2003)   Sex   M   F Affiliation (eg: College/University/Club)   Personal best ergo time   2000m :    1000m : Fees: Cheques to be made payable to The Gingerbread Guild   Payment prior to October 27th 2003 Payment after October 27th 2003 Race     Full time students $ 25.00 $ 32.00 Others $ 35.00 $ 45.00 Rowathon $ 100.00 $ 125.00 Important : If on race day you should feel unwell, or have recently suffered from a virus, we recommend that you do not row. Indoor rowing and racing can involve important physical effort and the organisers and sponsors take no responsibility for illness or injury caused as a consequence. WAIVER and RELEASE The undersigned hereby releases and discharges The Gingerbread Guild, including but not limited to its administrators, directors, agents, officers, members, volunteers and employees, other participating, regatta organisers, any sponsors, advertisers, and if applicable owners of premises where the regatta is held, known hereafter as the “Indemnitees” from all liability, claims, demands losses or damage, including legal fees, caused or alleged to be caused in whole or in part by the negligence of the “Indemnitees”.       I have read the terms and conditions of the Quebec Indoor Rowing Challenge and also the conditions of this WAIVER and RELEASE and confirm that I fully understand same and have signed freely and without inducement. Name of participant Telephone Date   Parental Consent for Minors I, the minor's parent and/or legal guardian agree to the participation by the minor in this event and agree that the terms and conditions applicable to all participants shall apply. Name of parent/guardian Telephone Date