www.runningdiary.co.uk ...to find your next race	Universal Entry Form NICOLA'S 5, Canvey Island Sunday 20th April 2008
Surname:	Postal Address:
Firstname:
Date of Birth:
Age on Race Day:
Gender:MaleFemale	Postcode:
Affiliated Club:	Telephone:
Registration Number:	Fax:
Entry Selection: (tick as appropriate) 5 mile road race    60 yard fun run    200 yard fun run    5 mile walk	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: Entry form or letter with entry fee payable to ROAD RACE ACCOUNT to Steve Kemp, 62 Tilburg Road, Canvey Island, Essex SS8 9ER

Entry Fee: £4 attached, £6 unattached

Notes: Very fast flat charity road race raising funds for Gt Ormond Street Hosp. Attracts 600 runners. Course rec: Rob Denmark 23:56. Walkers welcome (starting at 10:15). U/7 and U/11 CHILDRENS RACES 9:45am.

For Official Use Only

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