THE TARRANT VALLEY 10K - 19.7.2009 10:30am
THIS FORM HAS TO BE POSTED TO US SO THAT WE HAVE A SIGNED COPY
COULD YOU PLEASE FILL IN ALL RELEVANT BOXES IN BLOCK CAPITALS
PLEASE READ THE NOTES AT THE END OF THE PAGE
| NAME | |
| SEX M/F | |
| AGE ON 19/07/09 | |
| D.O.B | |
| ADDRESS | |
| POSTCODE | |
| PHONE | |
| UKA AFFILIATED CLUB | |
| NON-AFFILIATED CLUB | |
|
FEES: TV10K:Minimum age is 15 years |
Please make cheques payable to Tarrant Valley 10 |
| UKA CLUB MEMBERS £6.00 | |
| NON UKA £8.00 | |
| CHILDREN 1 MILE RACE (boys under 14, girls under 15) £1.00 | |
| ENTRY ON THE DAY: £1 extra |
|
I declare that I am an amateur as defined by UK Athletics.
I agree to abide by the current laws and rules of competition of UK Athletics
and local rules. I agree not to hold the organisers responsible in any
way for injury or loss as a result of my participation in this race.
|
| SIGNATURE | DATE |
PLEASE NOTE:
Minimum age for TV10K is 15 years
The children's race is not covered by the race permit
Closing Date for receipt of prepaid entries: 17th July 2009
Race numbers will not be sent out but will be ready on the day
Entry On the Day: £1 extra
Please use the on-the-day forms available at the entry desks, NOT this one.
Prizes will be listed on the day, the number depending on entries
The Langton Arms will be open from 12:00 for an extensive range of food and drinks
Please send this form to the address below
| The Race Secretary, | Phone +44 (0)1258 830247 |
| Tarrant Monkton House, | |
| Tarrant Monkton, | |
| Blandford Forum, | |
| Dorset, | |
| DT11 8RU. |
To Make Further Enquiries Please See Our Contact Page