The Terminator Entry Form - 24 February 2008

 

A 10 ish Mile Multi-Terrain Race, starts at 10.30am and finishes at Pewsey School Wiltshire. Please complete in block capitals.

Surname:    

Forname(s):

Address:   

Postcode:                 Telephone:

Team Name: 

UKA Affiliated Club:

Age on Race Day (min 17yrs):               Date of Birth:

Male/Female:         E-mail:

At the moment I can't seem to get a 'Print' Button working, sorry. Take a look on the internet window toolbar to print the form. If not, 'Copy' the form and then 'Paste' it in a Word Programme to print the form. 

T-Shirt size required:   S()    M()     L()     XL()  

Entry Fee: £10 Affiliated     £12 Unattached   (£1 extra on day)
Cheques made payable to Pewsey Vale Running Club

I declare that I will abide by the UKA rules. I am medically fit to run and understand that I enter at my own risk and that the organisers will not be held responsible for any loss, damage, action, claim, injury or illness which may arise as a result of my participation.

Signed: ________________________________________________

Date:____________________________

Please send completed form and cheque to Race Secretary:
Richard Pearce, The Old Orchard, Rudge Lane, Oare, Marlborough, Wilts SN8 4JH (Phone 01672 562412).

Include 9x4 self-addressed stamped envelope, entries after 22/2/08 to be collected on the day.