In order to process your registration, it is mandatory to fill the form, attach the fee and airmail it no later than March 24, 2003. Please fill the form in print letters, sign and enclose a 20 U.S. $ registration fee. Checks will be drawn on the name: Galil Tachton Municipality. Please mail it to: Sport Dept., Galil Tachton Municipality, Doar-Na Galil Tachton 14101, Israel.

Last Name ________________________ First Name ______________________

Male ___ Female ____ Year of Birth 19____ Phone____________________

Street___________________ No.______ City___________________________

Country __________________Society/Group____________________ Bib # ______

I am aware that a field/road running a race is potentially hazardous activity. I should enter and run unless I am medically able and properly trained. I certify that I am in good health and have no physical condition that would prevent me from participating. I assume all risks associated with running this event, including but not limited to contact with other participants, effects of weather, conditions of all the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting, I for myself and anyone entitled to act on my behalf, waive and release the municipality of Galil Tachton and all sponsors of this race, their representatives and successors, from all claims and liabilities of any kind, arising out from participation in this event I agree to indemnify the municipality of Galil Tachton and all sponsors of the race against all liabilities for any loss, cost, injury or damage to persons or property which may arise.

I am over 18 years old. Signature ___________________ Date __________