the race entry form

Sunday 28th June 2015 10:30am
The Gibbet Challenge is a scenic, multi-terrain 10K race in the beautiful countryside around Inkpen, West Berkshire, and
includes a climb up to Combe Gibbet to enjoy the spectacular and far-reaching views.
Trophies will be awarded for the first three male/female finishers and fastest male/female veterans over 40. All finishers will
receive a commemorative medal. Any proceeds from the event will go to the Inkpen Sports Clubs Association with the aim of
encouraging sporting activities within the village.
The race starts and finishes at the Inkpen Memorial Playing Fields, Post Office Road, Inkpen, RG17 9PU. All entrants must be
at least 16 years of age on the day of the race. Regrettably the course is not suitable for wheelchair competitors or
pushchairs. You can find the latest race information at www.gibbetchallenge.net.
Category:
Male / Female
First Name: _________________________________ Last Name: ___________________________________
Address:
________________________________________________________________________________
________________________________________________________________________________
Post Code:
________________________________
Age on Race Day: ______________________________
Tel No:
________________________________
Date of Birth: _________________________________
Entry Fee (£8 affiliated / £10 unaffiliated, add £2 for on-the-day entry): __________
Club Name (for affiliated entry): _________________________________________
Cheques should be made payable to Inkpen Gibbet Challenge
E-mail address: _______________________________________
_
Declaration:
I understand that the event is held under Association of Running Clubs Rules and agree to abide by these, the event rules and
directions of race marshals. I enter at my own risk and will not participate unless I am medically fit. The event organisers and
sponsors and their agents will not be held responsible for any injury, loss or expense as a consequence of my participation in the
event. I will not give or sell my race number to anyone else and accept that no refund will be given if I cancel my application for
any reason. I understand that there is a cut-off time of 2 hours for runners to complete the course. Runners not completing the
course within this time will be withdrawn and the organisers will not accept responsibility for them. I accept that photos of the
event may be used in appropriate publications. Gun times will count for positions and prizes.
Signed: _______________________________________
Date: ______________________________________
Please return your completed form to: Gibbet Challenge, Combe Haven, The Firs, Inkpen, Berkshire, RG17 9PT
Email: [email protected]
Note that all race numbers should be collected on the day (Race HQ will be open from 9am).