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| 26th July 2009 | ||||||||||
Please
fill in all sections applicable (captains name only for relay race team)
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| First Name |
Last
Name |
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| Address | ||||||||||
| Town |
Tel
Day |
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| County | Tel
Eve |
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| Post code |
Nationality |
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| D.O.B |
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Sex |
Male Female | |||||||
Age
on 31 Dec 2009 |
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| Will 2009 be your first year competing at triathlon ? |
Yes
No
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| Will you be a BTF member on race day ? | Yes
No
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| Team or club name (if any) | ||||||||||
| T-shirt size S M L XL | ||||||||||
| Relay second team member S M L XL | Relay third team member S M L XL | |||||||||
| How did you get to know about this triathlon event ? | ||||||||||
| Competed previously |
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220 Magazine |
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Poster |
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BTF mail out |
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| Told by a friend |
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Internet |
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| Other (Please specify | ||||||||||
| Please tick if you do not wish to receive information for our future events | ||||||||||
| ESTIMATED TIME swim 500m mins secs Sprint | |||||||||||||||||||||||||||||||||||||
RACE
SELECTION (Tick the box of the race/s you wish to enter) |
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For
entries received after the closing date of Monday 23rd July 2009 add
£10.00 late entry fee or entry will be returned (subject to availability, this does not guarantee your entry!). Sorry no entries on race day. No need to send S.A.E.’S. |
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| PAYMENT TOTAL ENCLOSED Credit Card, Switch or cheque | £ | ||||||||||||||||||||||||||||||||||||
| Card Number | |||||||||||||||||||||||||||||||||||||
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please make cheque/postal order payable to “Excellent Promotions” & post to Unit 20, Cockshades Farm, Wybunbury, Cheshire, CW5 7HA |
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I
want to compete for Cancer
Research UK
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| DISCLAIMER
Min age 14 (Novice/Sprint) 17 (Big Half) on the 31 Dec 2009. Parents signature
required for under 16. Unsigned entry forms cannot be accepted & will be returned. I declare that I am of good health & fit to compete in a triathlon & do so at my own risk. I will abide by the rules of the organisers and agree to their terms & conditions. I will cycle with care & attention & abide by the normal rules of the road. I accept that the organisers & their friends & associates are not liable for any loss, damage, claim, injury (including fatal) or expense that may arise in consequence of my participation in any of the above events. |
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