Entry Form: Autumn Mist Challenge - 19 May 2001 - 12, 6 & 3 hour Rogaine
Team details:					Print in nice clear hand writing please! J
12 hour		6 hour		3 hour		grade		
Full Name	Phone:	Signature: I am taking part at my own risk	
Address	Year born	email	
Full Name	Phone:	Signature: I am taking part at my own risk	
Address	Year born	email	
Full Name	Phone:	Signature: I am taking part at my own risk	
Address	Year born	email	

Number for camping:   Friday:_________  Saturday: __________	
Fees: ______ @ $25 / $15 = __________	
Entries postmarked after 9 May 2001 will have the late fee applied.	
Late Fee: _______ @ $10 per person__________	
Write cheque payable to: Wairarapa Orienteering Club
Post to: Liz Nicholson, SH2, RD1, Carterton	
TOTAL : __________