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Rosemere 10k Online Entry
Sunday 13th July 2008 at 11.00am

Please note that, after you click "Send it!" at the bottom of the page, you will go to a verification page. Once you are happy that your information is correct, you can submit your entry and move to the payment page. Sorry if this is a bit longwinded but it's necessary to ensure that your data is correct! In particular, please ensure that you select the correct age category to match your date of birth.

If you submit an online entry but then choose to pay by cheque, please indicate this on a clearly marked printed copy of this form attached to your cheque to avoid duplication, so we can delete the online entry form. The postal address is Ron McAndrew, Rosemere Cancer Foundation, Radiotherapy Department, Royal Preston Hospital, Fulwood, Preston PR2 9HT and you should enclose a cheque payable to "Rosemere Cancer Foundation" for £7 (club runners) or £9 (unattached) plus a 9x6 SAE for your race number etc.

There is a £1 handling charge for online entries BUT you don't have any stamps or envelopes to pay for! You will collect your race number on the day. Nochex and PayPal do not require information other than that which relates to your credit or debit card - no pesky registration requirements!
REMEMBER - ARRIVE IN GOOD TIME AND COLLECT YOUR NUMBER ON THE DAY!!

Starred items (*) must be completed (even if with "none")

Event entered * [Rosemere 10k - Attached @ £8.00]
   [Rosemere 10k - Unattached @ £10.00]
Select according to whether or not you are a UKA/ARC club member
Forename* 
Surname* 
If you have a name like MacDonald please enter with a space before the next capital as Mac Donald - to ensure correct capitals.
House name and/or address*   e.g. 1 Smith Street
Second line of address     e.g. off Main Street
District     e.g. Smalltown
Town*   e.g. Bigtown
County*  Postcode *
   If you are from an address outside the UK select "Outside UK" at the bottom of the list.
Telephone* 
Email address* 
Gender*Male Female
Age on 13th July 2008* 
Date of Birth - select from boxes* Day: Month: Year: (Your race category is based on age at 13th July 2008 - min age 15)
Club, Association or School (or 'Unattached')* 
(You MUST be a member of a UKA/ARC affiliated club to pay the lower rate of £8.00 - if you pay the wrong fee you will have to pay a further £2 at registration before you collect your number)
UKA/ARC Reg No (or 'none')*  If you know your UKA/ARC registration number enter it here otherwise leave as "none"
If you want to add specific information (e.g. medical problems), please do so here.
    

Disclaimer and agreement - Please enter me for the above event. I hereby declare that I am an amateur according to UK Athletics laws. I am medically fit to take part. I agree that the organizers and/or sponsors shall not be responsible for any loss, accident or injury (or loss/damage to my property) arising from my participation in this event.
Data Protection information - your details will be retained on computer by the organisers and UK Results only for the purposes of this event and any future events promoted by the club and will not be passed to anyone except for emergency services use, if appropriate.
I accept the above terms and conditions (please tick for online entry or sign (parent or guardian if entrant under 18) if posting a completed form with cheque) *

Click "Send it!" to complete your entry and move to the verification page.

or "Clear details" if you need to delete your details and re-enter them.