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Full name:
.. Sex: m/f
.. D.O.B.
. Age on race day
..
.
Address
.
Post Code:
...
Telephone Number:
...Club
.
I declare that I am medically fit to run and understand that I take part entirely at my own risk and I
accept that the organisers of the event will not be held responsible for illness, injury or loss of property
that occurs in connection with this event.
Signed:
...Date
.
Return to : , Jillian Hill, 73 Sutherland Road, Cheslyn Hay, Walsall WS6 7BT
Enclosing a 9"x 6" S.A.E. ( entries without an enclosed S.A.E. must be collected on race day)
Please make cheque payable to : SNEYD STRIDERS R.R.C.
Race Director Richard Johnson
To obtain more information or to download this form log on to our web site at www.sneydstriders.org.uk
Or contact us by e-mail at pudrun@sneydstriders.org.uk
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