10K Entry Form

Crossdale 10K Trail Race - Early Bird Entry Form
UK Race Licence Number 2010-100676
Sunday, 26th September 2010, 10:00am

This entry form has been designed for you to print onto A4 paper. Either type your details in the boxes, or fill in by hand.

If the print seems too big or too small, try changing the text size in your browser's view menu.

Please send your completed registration form with an A5 stamped addressed envelope and correct entry fee to:

Crossdale Trail 10k & Fun Run, Keyworth, Nottingham NG12 5HP

Cheques payable to Friends of Crossdale. Closing date for early bird postal entries is Friday 2 July 2010. After this date only standard entry forms will be accepted.

Please Note : Race numbers and information will be sent out after the closing date.

Contact details

First Name

Surname

Address

Postcode

'Phone

Date of Birth

Female

Age on Race Day

Male

Tick here if you want to be emailed about next year's event

How did you hear about the event?

Signed

Date

Race Number

(For Official Use Only)

Conditions: 10k runners must be at least 15 years of age on race day. Under UK Athletics rules, a signed entry for this event will be considered a declaration that you will run entirely at your own risk, and that you have no medical disabilities that would endanger you or others taking part. Entries accepted until 9:40 on the day, up to a maximum of 350 entrants. No refunds in the event of withdrawal. The Race Director's decision is final. Course changes, if necessary, will be posted on our web site. Prizes are awarded on a one runner - one prize basis. The off-road nature of the course renders it unsuitable for wheelchair athletes.

Entry details - please fill in the relevant column

Club Name

Tick here if attached but are not registered with a National Association.

Total Early Bird Entry Fee

15% discount for early entry

Standard Race Entry Fee

Tick here if unattached

Total Early Bird Entry Fee

15% discount for early entry

Standard Race Entry Fee

* Please note : Both club name and EA registration number must be provided to qualify for the £2 insurance discount. For details see the link on the main entry page of our website - www.crossdale10k.co.uk.

Tick here if attached and are registered with a National Association.

Club Name*

Total Early Bird Entry Fee

EA Registration Number*

15% discount for early entry

Standard Race Entry Fee

£2.00 insurance discount*