Race Number     __________

 

 

SHUTLINGSLOE FELL RACE – REGISTRATION FORM

 

 

Full Name            ____________________________      Age   _______

 

Address              ____________________________________________

 

____________________________________________

 

Phone No.           ___________________    Vehicle Reg. ____________

 

Email Address    ____________________________________________

 

Club                     ____________________________________________

 

Category (tick as appropriate)

 

Open Race

Junior Races

Open

Lady

Vet (V40+)

Under 16

Local[1]

Age at 31 May 2011 (Min. 12)

Under 10

Under 12

 

 

 

Age at 30 May 2011 (Min. 8)

 

Emergency Contact  __________________    Phone No. ____________

 

I understand that this race is held in accordance with both the rules and safety requirements of the FRA.  I confirm that I am aware of the organiser’s information and requirements in connection with this race.  I accept the hazards involved in fell running and acknowledge that I am entering and running this race at my own risk.  Other than the organiser’s liability for causing death or personal injury by negligence, I confirm that I understand that the organiser accepts no liability to me for any loss or damage of any nature to myself or my property arising out of my participation in this race.

 

Signed       _________________                    Date  _________________

(Signature of Parent/Guardian if under 18)



[1] Resident of the parishes of Wildboarclough, Macclesfield Forest or Wincle