Myra Garret Entry Form 2012

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Myra Garret Entry Form 2012 Powered By Docstoc
					                                                          Bexley AC 10k
                                                          Myra Garrett Trophy
                                                                  &
                                                               Fun Run
                                   Sunday 20th May 2012
                    Danson Park, Danson Road, Bexleyheath, Kent. DA6 8HL
About the Races                                                                               How to Enter
         Event                 Distance       Start Time Qualifying Age                       Please complete the entry form and send it
        Fun Run                 3,000m         10.00am        Any                             with your entrance fee and a LARGE stamped
        Open 10K               10,000m         11.00am 16+ on day of race                     address envelope to:

Both races will be run over a multi-terrain course within the                                 Entries Secretary, 128 Okehampton
confines of Danson Park. Unsuitable for wheelchair users                                      Crescent, Welling, Kent, DA16 1DB

Prizes
All Competitors in the Fun Run and 10K will receive a souvenir                                Please make your cheques/postal orders
memento. Spot prizes will be awarded at the finish. For the 10K,                              payable to Bexley AC and return your form
trophies and Sweatshop vouchers will be awarded to the                                        by 12th May 2012
following value:
First 3 Male and Female finishers - £25, £20, £15                                             Entries fee:
First Veteran: Ladies 35/45/55 Men 40/50/60 - £20                                             10k affiliated £8.00 unaffiliated £10.00
First Male and Female teams - 3 to score                                                      All entries on the day £3.00 extra.
£25 cash prize for breaking course record                                                     Last entry 10.30am
                                                                                                                                         official use
(M) 32.20 Paul Maryelletti 2011 Victoria Park Harriers
(F) 37.30 Maria Heslop 2011 Paddock Wood AC                                                   Fun Run £3.00
Please note: Entrants will only be eligible to receive one prize per race except for new course record.

Tear ---------------------------------------------------------------------------------------------------------------------------------------------- Tear

Entry Form 10K                               Fun Run                                                        Permit applied for.

              Surname:
             Forename:
                     DOB:                /            /                         Age on Day                                Sex M                  F

                     Club:
         Licence Number                                                         All affiliated entrants must be individual members of England Athletics

               Address:



            Post Code:                                                     Contact Number:

                   Email:
                              I declare that I will be over 16 years of age on the 20 May 2012, that I am an amateur as defined by UK
                              Athletics and that I will abide by the laws and rules of UK Athletics. I agree that Bexley AC will not be held
                              responsible for any injury, loss or illness to my person or property as a result of my entering this event. I
                              further declare that I will not compete unless I am in good health on the day of the race and that I do so at
                              my own risk.

            Signature

                              Please tick box if you do not wish your details to be passed on to our sponsors

                              Entries on line at www.runnersworld.co.uk for printable entry formwww.bexleyac.co.uk

				
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