Meanwood Trail Race Entry Form

Meanwood Valley Trail 2009 - 14^th Senior Race / 6^th Junior Race - ENTRY FORM

First Name ________________________ Surname ___________________________

Address ______________________________________________________________

______________________________ Postcode_________ Date of Birth ___________

Telephone Number ____________________________ Age on Race Day ________

Affiliated Club (or organisation) ___________________________ Sex (M/F) ______

UK Athletics reg.no. _________________ Email address ________________________________

DECLARATION: I declare that I am an amateur according to U K Athletics laws. I understand that I take part entirely at my own risk and accept that the organisers shall not be liable for any injury or illness to my person as a result of taking part, nor for any damage to or loss of property.

Signature _________________________(signature of adult if 16 or under) Date ______________

*{I am enclosing an S.A.E.}/*{I will collect my number on race day} ... *^{DELETE WHICHEVER DOES NOT APPLY}

Fee enclosed _________ Optional additional donation to Lineham Farm enclosed _________

Gift Aid: Please help us to make your ‘additional’ donation worth even more. If you are a taxpayer we can reclaim the tax from this. Currently we reclaim 28p from every £1 given.
Please tick the box if you pay UK Income or Capital Gains Tax and you wish Lineham Farm Children's Centre to reclaim the tax on your donation o
NB we can only reclaim on the additional donation, not on the entry fee.
If you require a Sponsorship Form to be sent to you (no obligation) or would like more information about Lineham Farm, tick hereo

Click here for Race Details