otherwise known as
Fees: £5.00 attached. £6.00 unattached. £1.00 surcharge for entry on the day
Medals to all finishers
SEND S.A.E. MINIMUM SIZE 9" X 5" FOR RACE NUMBER
SEAA Road Race Permit applied for.
First Name:____________________________ Surname:_____________________________________
Date of Birth: ____/____/____ Male/Female Club:_________________________________________
CHEQUES PAYABLE TO MABAC
I declare that I will only take part in the chosen event if I am fit to run and I will not hold the organisers responsible for any loss or injury however caused.
Data protection. Your details are held on computer for our own use only and will not be passed to any third party except for publication of results. We may from time to time send you details of other events that we organise, if you do not wish to receive such details, please tick this box q
Entries to: The Event Secretary, 10A Clifford Grove, Ashford, Middlesex, TW15 2JT
Don't forget your S.A.E.
www.mabac.org.uk E-mail MabacLeag@aol.com