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13th BMAF CROSS COUNTRY RELAY CHAMPIONSHIPS
Organised by Mansfield Harriers AC under UKA & BMAF Rules |
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at
OFFICIAL ENTRY FORM
Data
Protection Act - the details provided on this Entry Form will be entered onto
a computer
for use by this event, but will not be passed to any third party.
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Name of UKA Club |
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Club Colours |
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Contact Name |
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Position |
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Address 1 |
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Address 2 |
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Address 3 |
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Postcode |
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Home telephone |
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Mobile telephone |
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Email address |
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Declaration |
On behalf of my Club, I confirm and accept that: ·
all athletes listed here are bona fide first claim members of this
Club and eligible to compete ·
all athletes listed here are members of a masters/veteran club ·
all athletes listed here are members of a UKA registration scheme ·
all athletes listed here are amateurs as defined by UKA and agree to
abide by their Rules ·
none of the organisers, sponsors or their servants will be liable for
any injury, illness or loss (howsoever occasioned) resulting from my Club’s
participation in this event ·
the Secretary of this Club has countersigned this Entry Form if I do
not hold that position |
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Signature |
Date |
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Countersigned by Secretary |
Date |
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| Please state no. of teams in each age group: | M35 _ | M40 _ | M50 _ | M60+ _ | W35 _ | W45 _ | W55+ _ |
| Fee per team | £ | £ | £ | £ | £ | £ | £ |
Total fee enclosed £ __________.
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__ 13th BMAF CROSS COUNTRY RELAY
CHAMPIONSHIPS Organised by |
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OFFICIAL ENTRY FORM
Race 1 - start 12.30
pm - W35+, W45+, W55+, M60+
Race 2 – start 1.15
pm – M35+, M40+,
M50+
I
wish to enter the following runners ( up to a maximum of 9 ) for the BMAF XC
Relay Championships.
I
declare that all runners listed are fully paid up members of a masters/veterans
club and the UKA registration scheme. I understand that failure to do this may
result in the runner and the club being disqualified.
Signed …………………………………………………………Position in club ……………………..
RACE
Gender/ Age ………….
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Surname |
First name |
UKA Registration Number |
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Please use a separate form for each Gender/Age team entered
Please make your cheque payable to Mansfield Harriers AC and send it
with 2 SAE ( A5 ) size to:
Race
Director, 2008 BMAF XC Relays, 28, Vale Close, Mansfield, Notts NG18 4HR