F 20120424 010731 epic relay 2012 regform

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TEAM REGISTRATION FORM (FORM A-1) (To be accomplished by Team Captain and Co-Captain) Team Running Pace* _____________

(Please print all entries clearly)

CATEGORIES Corporate / Call Center (must belong to the same company)

GROUP NAME:

All Men

Team Captain:

Mix (Men & Women)

Address:

Ultra (5 members only) APPLICABLE FEES

Email Address:

Php 13,500 per team for Categories: Corporate / Call Center, All Men, Mix

Phone Number/s:

Php 10,750 per team for Category: Ultra

Co-Captain:

PAID AT CHRIS SPORTS ________________________ BRANCH,

Address:

RECEIPT NUMBER ________________ All paid fees are non-refundable. Substitution of members is allowed. (Rules and deadlines apply)

Email Address:

NAME

MEMBERS ADDRESS

E-MAIL/CONTACT

NAME

RESERVES (To be filled out only for substitution purposes) ADDRESS

E-MAIL/CONTACT

As team captain and c o-captain, we agree to accept and follow the rules and responsibilities set by the organizers of the Epic Relay, to be responsible for our teammates’ well-being for the duration of the event, and act as representatives for the team in meeting called by the organizers. Team Captain’s Signature Over Printed Name * To register, please fax completed form to +632 759.6690. For inquiries, you can call Ms. Kate Ong or Carl Llado at (+632) 845.1324. You can also e-mail kate@eccp.com.

Co-Captain’s Signature Over Printed Name

Visit www.eccp.com for more info.


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