TEESDALE ATHLETIC CLUB

Raby Castle 1OK

Staindrop (2 lap traffic free course)

Plus 5K Fun Run

By kind permission of Lord Barnard. Permit applied for.

Sunday, 30th May, 2004

 

Fun Run 10.30 a.m. Medals to all finishers

10K Run 11.15 a.m.

Prizes for all leading finishers Male, Female & Veterans

T Shirts to all finishers of 10K Run

www.littleredfrog.com/teesdaleac

                                               

 

­ENTRY FORM

Please complete in block capitals

 

Surname ..........................................................................

M/F ....................................................................................

First Name ......................................................................

Date of Birth ..................Age on day of race.................................

Address ........................................................................

Athletic Club......................................................................

             ........................................................................

Athletic Reg No. ................................................................

             ........................................................................

Telephone No ....................................................................

Post Code ........................................................................

E-mail ................................................................................

 

 

10K Race:             Entry Fee    q£7 attached                     q £8 unattached

                               Min. age 17 years

 

5K Fun Run:         Entry Fee q £4                    Results on-line

 

Total Enclosed

£

 

 

Closing date for postal entries Friday, 7th May

Entries on day additional £1 per entrant

 

Cheques/P.O.s made payable to Teesdale Athletic Club plus a S.A.E. 10" x 8" for race number and details to:

TEESDALE ATHLETIC CLUB

HOW TALLON, BARNINGHAM, Nr. RICHMOND, NORTH YORKS., DL 11 7DU

DECLARATION: I declare that my participation in this event is entirely my own risk and that none of the organisers or sponsors of the event, nor their members, servants or agents shall be liable in any way whatsoever in connection with any loss, damage, injury or death either caused to, or suffered by or caused by me. Neither are they responsible for any of my personal property lost, stolen or damaged.

 

Signature......................................................................................                                                                        Date..........................................................................

(Parent or Guardian if under 17)