1. No category

KYMIN DASH ENTRY FORM
19th April 2015 – 11am
Name:
Address:
Male or Female:
Age on race day:
Team:
(Optional)
Running Club:
(Or Unaffiliated)
Welsh Athletics Registration:
Postcode:
Email address*:
Telephone:
Entry Fees
By Post
On Day
Affiliated
Unaffiliated
Affiliated
Unaffiliated
£10
£12
£12
£14
January
2015 Early
Bird
£8
£10
I declare that I am an amateur as defined by UK Athletics rules.
I enclose my cheque for £__ payable to Spirit of Monmouth RC
I understand that this is a strenuous event (multi terrain, 7.1 miles approx, 800ft climb) and that parts of the climb are shared with
road traffic.
I hereby agree that the organisers shall not be liable for any injury, loss or damage sustained as a consequence of my participation in
the Kymin Dash.
UK Athletics rules apply. Permit number TBA from Welsh Athletics [AAW].
Signed: .............................................................
Please send your completed entry form to:-
Any queries, please contact Emma King.
Karen Barratt
Tel: 07841135737
40 Wyesham Road
Email: [email protected]
Wyesham
NP25 3JR
*Your email address will only be used by us to contact you about this and other events Spirit of Monmouth Running Club are involved with.