Rowbotham's Round Rotherham   Individual Entry

This form is for pre-entries
(or print the postal entry Adobe Acrobat version) 
Post to RRR Entries, 43 Spinneyfield, Rotherham, S60 3HT with your entry fee 
2 SAEs, for confirmation/final details (to 25 Nov) and results.  Entry enquiries 01709 540242

Date: Second Saturday in December

Start and Registration at the DVC Sports, as for 2006. 
Manvers Park, Wath upon Dearne, Rotherham  S63 7EW, Grid Ref SE 455003
The College is signed from the Manvers roundabout (SE 454008) on the A6023. 
Name (first name and surname)
Club (for Team competition)
1st claim athletics club (or TRA, FRA, RRC)  
Start time (please circle) Walkers 06:00 - Runners 07:00 
Have you done this event before? (Approx.) No. of finishes:
If none, have you entered or started before?
Male or Female
Age on day (Absolute minimum 18 years)
(please contact organiser if under 21)
Date of Birth  
Sleep at the Event Centre on the Friday night (7 Dec)? - add £4.00  
Shirt size S, M, L, XL for commemorative leisureware  
Fee (please circle) Cheques to RHAC Attached to UK: Athletics  £10.00 Unattached / LDWA
£11.00		 Late entries, after 3 Dec £15.00

I absolve the Organisers and Rotherham Harriers and Athletics Club from responsibility for my safety in the Round Rotherham event. I understand that TRA/UK:Athletics rules apply. I understand that entries and results will be processed by computer and that the data will only be used in connection with the Round Rotherham event. Retirement must be reported to an official at a checkpoint or the Event Centre. Entries can only be accepted subject to these conditions.

Signed: _________________________________________ Date: ____ / ____ / 20___

Addresses (postal, inc post code:

 

e-mail (please write clearly):
 

Vehicle Registration and Type

  

Travelling Companions

 

  

Home Telephone: ( in case of emergency)

Mobile Telephone (if carried):