Sticker AFC Football Club Cornwall
Sticker AFC Football Club Cornwall

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 sticker 5 mile Sponsor Ad 4

 

 

 

 

 

STICKER 5

Entry Form

FIRST NAME………………………………………SURNAME……………………………………………………………………

ADDRESS……………………………………………………………………………………………..POST CODE……………….

TELEPHONE…………………………………E-MAIL………………………………………………………………………………

DATE OF BIRTH……………………………AGE ON DAY……………………………..MALE/FEMALE……………….

AFFILIATED: YES/NO……………….U.K.A. RACE LICENCE NUMBER………………………………………………

RUNNING CLUB………………………………………………………………………………………………………………………

DATA PROTECTION: The information provided by you on this form will be used solely for the purpose of race results, and identification for health and safety reasons. The information will only be available to the results team and appropriate race officials, and will not be passed to any other person or agency.

DECLARATION: I understand that while the organisers make every effort to ensure my personal safety, they will not be responsible for any injury, loss or damage incurred by me during the race.

I am over15 years of age

THE USE OF I'PODS, MP3'S etc, BY COMPETITORS WILL MEAN DISQUALIFICATION.

Signed……………………………………………………………………………………….Date…………………………………….

Please return completed forms to: Denise Pooley

16 Southdown Road, Sticker, St Austell, PL26 7EW.

E-Mail entries to: This email address is being protected from spambots. You need JavaScript enabled to view it.

Race entry fees: £10 affiliated runners, £12 unaffiliated runners.

PLease note there will be a surcharge of £3 for entries on the day.

Block entries to be received by Sunday, June 18th.

All runners to receive a memento and a pasty. All runners will receive a memento and pasty.

Please make cheques payable to Sticker AFC. Race numbers can only be collected at Registration. Race enquires to Malcolm Vian - 01726 - 61973

 

 

STICKER AFC

1 Mile Fun Run

Sat, June 24th

Start 5.30pm

Sticker AFC, Burngullow Park, Sticker, PL26 7EW.

Trophies sponsored by St. Austell Trophies.

1st, 2nd, 3rd Male  1st, 2nd, 3rd Female.

Memento to all finishers.

First name........................................ Surname...................................

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

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

Date of birth...................... Age on day......Male/Female..................

School/Running club.........................................................................

If under 18 Parent/Responsible adults' signature required.

Signed...............................................................Date............................

Please return entry forms to:

Anne Bullock, 8 The Meadow, Polgooth, St. Austell, PL26 7BL.

Race entry fee £3.50  Please make cheques payable to Sticker AFC.

Race numbers can be collected at race registration.

 

 

 

 

 

 

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