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Pudsey 10k Challenge Online Entry
Sunday 27th July 2008 at 10:45am

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 include your correct age AS AT RACE DAY.

If you submit an online entry but then choose to pay by cheque (£7 attached, £9 unattached) payable to "Pudsey Pacers RC" with 9x6 SAE, please indicate this on a clearly marked printed copy of this form attached to your cheque to avoid duplication, so we can delete your online entry details. The postal address is Race Secretary, 6 Apple Close, Birstall, Batley, West Yorkshire WF17 0DZ. A paper entry form can be downloaded - click here (acrobat .pdf). You can telephone enquiries to 07961 867560.

There is a £1 handling charge for online entries BUT you don't have any stamps or envelopes to pay for and your race number will be posted to you in advance of the race. Nochex and PayPal do not require information other than that which relates to your credit or debit card - no pesky registration requirements!

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

Event entered * [Pudsey 10k Challenge Attached @ £8.00]
   [Pudsey 10k Challenge 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. Smallville
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* 
Your age at 27/07/2008* 
Date of Birth - select from boxes* Day: Month: Year: (Your race category is based on age at 27th July 2008 - min. age 16 on race day)
UKA/ARC affiliated Club
name/Business team/Unattached		* 
(You MUST be a member of a UKA/ARC affiliated club to pay the lower rate - if you pay the wrong fee you will have to pay a further £2 at registration before you collect your number). Teams of 3 can count from businesses if you wish to enter a business team.
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 England Athletics rules. I understand that I take part entirely at my own risk and accept that the organisers shall not be liable for any injury or illness to my person as a result of taking part, nor for damage to or loss of property. I have no medical disabilities which would endanger myself or others taking part.
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 would like to raise sponsorship for Marie Curie
I accept the above terms and conditions (please tick for online entry or sign if posting a completed form with cheque for the correct amount plus SAE) *

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.