CITY PARKS GRAND PRIX
2008 ENTRY FORM
SURNAME .................................... FIRST NAME ..................... DATE OF BIRTH / / M or F ........... AGE ON THE 13th MAY 2008 ............ CLUB OR TEAM ........................................................................... NSRRA No. .............. ADDRESS ...................................................................................... ...................................................................................... ...................................................................................... ...................................................................................... POST CODE ................................................ PHONE NUMBER ......................................................................TICK WHETHER YOU WISH TO BE ENTERED FOR ONE OR MORE OF THE RACES.
|
VENUE |
DATE |
U/15 - 2KMS |
U/17 - 3KMS |
ALL MEN & LADIES - 5KM |
|
LONGTON |
13th MAY |
|
|
|
|
TUNSTALL |
3rd JUNE |
|
|
|
|
FENTON |
8th JULY |
|
|
|
|
HANLEY |
19th AUG |
|
|
|
|
ALL RACES |
|
|
|
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I DECLARE THAT I WILL ABIDE BY THE LAWS AND RULES OF UK ATHLETICS. I ACCEPT THAT THE ORGANISERS WILL NOT BE LIABLE FOR ANY LOSS, DAMAGE, ACTION CLAIM, COST OR EXPENSE WHICH MAY ARISE IN CONSEQUENCE OF MY PARTICIPATION IN THIS EVENT. I DECLARE
THAT I WILL NOT COMPETE UNLESS I AM IN GOOD HEALTH ON THE DAY OF THE RACE AND THAT IN ANY EVENT I WILL ONLY COMPETE AT MY OWN RISK.Signature ..................................................................
Parent or Guardian must sign for U/15 entry.
Entry Fees
Individual Races ... U/15 & U/17 £2.00 Senior Races £4.00
Full series ... Senior …… £15.00 : U/15 & U/17 …… £7.00
Unattached Senior Runners £2.00 extra per race entered.
Payable to "CITY PARKS GRAND PRIX"
Entries to Race Secretary ,
6 Gardenholm Close ,
Lightwood ,
Stoke-on-Trent ,
ST3 7YQ.
Enquiries either Ken Rushton 01782 330853 or Allan Simpson 01782 337266.
E-mails to Ken : suken@run222.freeserve.co.uk