www.runningdiary.co.uk ...to find your next race	Universal Entry Form Essential Sports Banbury 15 Sunday 20th March 2011
Surname:	Postal Address:
Firstname:
Date of Birth:
Age on Race Day:
Gender:MaleFemale	Postcode:
Affiliated Club Name:	Telephone:
Registration Number:	Fax:
Entry Selection: (tick as appropriate) 15 mile road race    1 mile fun run    2 mile fun run	Email Address:

Age Limits Competitors must be aged at least: 18 years for a marathon 17 years for a half marathon 16 years for a 10 mile race

Declaration A signed entry form will be considered as an acceptance of governing body rules and a declaration that you compete entirely at your own risk.

Signed:

Date:

Entry Instructions Provided by Organiser: post to Banbury Run, 6 Crouch Street, Banbury, Oxon OX16 9PP SSAE for race number/details

Entry Fee: £10 attached; £12 unattached. £1 extra ON THE DAY; 2M FunRun £4.50; team (5) £14; ( £1 extra on the day). u-14s race £1

Notes: Recognised VLM warmup race. Forget monotonous courses, this is seriously rural! 5 mins from M40 J11, canalside venue. 5 mins from Banbury Cross. Picturesque undulations. Water stations every 5M. Cheques payable: Banbury Harriers AC; postal CD 12 Mar 2011;

For Official Use Only

Remember to enclose a large SAE. Please do NOT make cheques payable to Running Diary. Either follow the organiser's instructions provided in the "Entry Instructions" section above, or alternatively leave the payee blank for the organiser to complete. Please add any further information which may be of use to the event organiser on the back of this sheet.

Data Protection: If you do not wish any details to be passed on to a third party, including other running related organisations such as the race photographer, tick this box