ON LINE ENTRY FORM - 10km -  UNAFFILIATED

Declaration: Submission of this on-line application acknowledges:  On the day of the race you will be over the stated min age limit and that you are medically fit to run and you enter at your own risk. The organisers will not be held responsible for any injury, illness, loss or damage as a result of you participating in the event.

1) Please complete the form then click the 'Submit' button.

2) Then Click the 'Back' button to return to this page.

3) Next - Click "Buy Now" button to make payment via Pay Pal.

You will receive an e-mail to confirm your registration.    Thank you.

YOU ARE REGISTERING FOR THE 10K RACE AS AN  UNAFFILIATED RUNNER FORENAME: LAST NAME: GENDER: AGE ON RACE DAY: DATE OF BIRTH: ADDRESS: POST CODE: TELEPHONE  # (Please insert your mobile number if you wish to receive your race result on your mobile after your race) EMAIL: ANY KNOWN MEDICAL CONDITIONS: PLEASE STATE TEE SHIRT SIZE - Small   -  Medium -  Large  .... NUMBER ATTENDING PASTA PARTY, SATURDAY EVENING - PLEASE NOTE: Closing date: 8th SEPTEMBER 2008 START TIME 09.35