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Haigh Hall 4 Mile Road Races Online Entry
Wednesdays 14 May (closed), 11 June, 9 July, 13 August 2008 at 7.30pm

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 (£4 attached, £6 unattached for single races, £12 or £20 u/a for the series) payable to "Wigan Phoenix" with 9x6 SAE (or collect on night), 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 Paul Carroll, 21 Pilgrims Way, Standish, Wigan WN6 0AJ. A paper entry form can be downloaded - click here (acrobat .pdf). You can telephone enquiries to Paul on 01257 426166 (evenings and weekends only please).

There is a £1 handling charge for online entries for individual races or £1.50 for the series BUT you don't have any stamps or envelopes to pay for and your race number will be available for collection 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 to allow for parking and collect your number on the day!

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

Event entered * Haigh Hall 4 (14 May) - online entry is now closed
   [Haigh Hall 4 (11 June) Attached @ £5.00]
   [Haigh Hall 4 (11 June) Unattached @ £7.00]
   [Haigh Hall 4 (9 July) Attached @ £5.00]
   [Haigh Hall 4 (9 July) Unattached @ £7.00]
   [Haigh Hall 4 (13 August) Attached @ £5.00]
   [Haigh Hall 4 (13 August) Unattached @ £7.00]
   Haigh Hall 4 Series - online entry is now closed]
Select according to whether or not you are an affiliated 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* 
  You won't get an acknowledgement of your entry if you don't enter your email address correctly!
Gender*
Please accurately indicate your
age as at your first chosen race date		* 
Date of Birth - select from boxes* Day: Month: Year: (Your race category is based on age at your first chosen race date - min. age 16 on race day)
UKA/ARC affiliated Club name
(or '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)
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 am an amateur as defined by UKA laws and rules. I agree to participate entirely at my own risk. I declare that I am medically fit to run and agree to be bound by the UKA rules.
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 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.