|
Race Entry Form |
||||
|
First Name:____________________________ |
Surname:______________________________ | |||
|
Address:__________________________________________________________________________________________________________________________________________ |
||||
|
Postcode:______________________________ Home tel no._______________________________ |
Mobile no.__________________________________________ |
|
||
|
D.O.B:_________________________________ C lub/school name: __________________________________________ |
email address______________________________________________________________________ please note this will only be used to contact you for confirmation of your race number. and to let you know about the next "slay the dragon" event. |
|||
| Age on 26/02/12:_____________ |
|
|||
| Gender M/F | ||||
| ( Please circle the event you wish to enter) | |
|||
| 'Slay the Dragon'10k run (Min age 15) | £8.00 |
|||
| 'The Dragon's Tail'4k run (Min age 11) | £5.00 | |||
| 2K Village Run (All Ages ) | £3.00 |
|||
| |
||||
|
Entries on the day £2.00 extra (except for the Fun Run) Cheques made payable to "Hinton St George PFA"
|
please send entry forms to "The Race Secretary"
Gardeners Cottage, 44 Broadway Merriott TA16 5QG
Please note -race numbers to be collected on the day
|
|||
|
I declare that I am an amateur as defined by U.K. Laws and agree to abide by their laws. I will be medically fit to run on the above date. I understand that the organisers of the event will not be held liable for any injury, illness or loss of property, however caused. |
||||
| Signed:___________________________ | Date:__________ | |||