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SATURDAY 3 RD JULY 2010,
10.30 AM START.
HILLY OUT AND BACK ROUTE, STARTING AT KINGHAM, PASSING THOUGH BEAUTIFUL DAYLESFORD ESTATE & CORNWELL AND BACK TO KINGHAM.
TOILETS, CHANGING FACILITIES AND PARKING.
ENTRY FEE £7.00 ATTACHED, £8.00 UNATTACHED.
ENTRIES ON THE DAY £1.00 EXTRA
ENTRIES TO : N.GOMM, 35 HIGH STREET, ASCOTT-UNDER-WYCHWOOD, CHIPPING NORTON,OXFORDSHIRE,0X7 6AW.
ENQUIRIES TO: njgomm@googlemail.com
PLEASE MAKE CHEQUES PAYABLE TO KINGHAM PRIMARY SCHOOL ASSOCIATION ( KPSA ) TOGETHER WITH A SAE .
ENTRY FORM
| SURNAME:.......................................................... |
FORENAME........................................................ |
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MALE/FEMALE |
AGE:............................ |
ADDRESS :…………………………………………………………………………………………….............................................
……………………………………………………………………………………………………………..............................................
…………………………………………………………….. POSTCODE…………………………….............................................
DISCLAIMER. I ACCEPT THAT I COMPETE IN THIS EVENT AT MY OWN RISK AND THAT THE ORGANISERS CANNOT ACCEPT LIABILITY FOR ANY ACCIDENT, LOSS OR DAMAGE AS A CONSEQUENCE OF MY TRAINING OR PARTICIPATION IN THE KINGHAM 10KM ROAD RACE.
I ENCLOSE A CHEQUE FOR £ ______ AND A SAE.
DATE…………................................................. SIGNATURE……………………………………...........................
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