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the entry form (word) - Preseli Bluestone Challenge

By Virginia Cruz,2014-06-18 01:12
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the entry form (word) - Preseli Bluestone Challenge

    Preseli Bluestone Challenge

    Fun Walk / Run Entry Fee ?5.00 Enw/Full

    Name ..............................................................................................................................................

Cyfeiriad/Address..............................................................................................................................

    ............................................................................................................................................................

Cod bost/Post code...............................................

Ffôn/Telephone........................................................email................................................................

    ....

Please complete this entry form and return to:- Mr Nigel Owen, PBC, Penrhiw, Fishguard,

    Pembrokeshire, SA65 9TD.

    The entry form should be accompanied by a cheque or postal order for ?5 made payable to The Rotary Club of Fishguard & Goodwick.

Only one entry form per participant. If you require more entry forms please enter the number required in the

    following box.

     Additional entry forms can also be downloaded from our website www.preselibluestonechallenge.com

Please help us to raise money for our nominated charities. Tick the box and we will send you a sponsorship

    form.

    I am aware of the Organiser’s information and requirements in connection with this fun run/walk. I accept the hazards involved in walking or running and acknowledge that I am entering and running in this event 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 property

    arising out of my participation in this event.

    Llofnod/Signature........................................................Dyddiad/ Date.............................................

take part for charity …………

     Cymrwch ran er budd elusen ……..

     This event provides the perfect opportunity for all participants to seek sponsorship.

     The proceeds of this event will be donated to the following Charities:-

     Local charities

     supported by Rotary

    Preseli Bluestone Challenge

     Organised by

    The Rotary Clubs of:- Fishguard & Goodwick, Haverfordwest & Cardigan,

     www.preselibluestonechallenge.com

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