Rowbotham's Round Rotherham

            Number Allocated:__________

Individual
Please circle: Changes to Pre-entries / Entry on the day

This form is not intended for pre-entries
 for postal entry print the adobe acrobat version, post to RRR Entries,  with your entry fee (cheques to RHAC) and 2 SAEs, for confirmation/final details and results)

Date: Second Saturday in December

Start and Registration at the DVC Sports
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 
For Entry on the Day participants
Have you done this event before? (Approx.) No. of finishes:
If none, have you entered or started before?
Male or Female
Age on day (Minimum 18 years unless accompanied)            years
Date of Birth           /              /

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___

For EOD (and, if changed, for pre-entries) Address:________________________________
                                                            __________________________________________

 

Vehicle Registration and Type  
Travelling Companions

 

 

Home Telephone: ( in case of emergency)

  

 Mobile Telephone (if carried):