THORNBURY RUNNING CLUB AQUATHLON

Entry Form

Sunday 13th March 2011

Bradley Stoke Leisure Centre, Fiddlers Wood Lane,

Bradley Stoke, Bristol, BS32 9BS

Short Distance - 500m Swim / 5K Run

Long Distance - 1000m Swim / 10K Run

1. Individual Race

2. Team Race - Two people enter. One completes the swim and the other completes the run. Teams can be made up of differing ages and gender.

Prizes will be awarded for both short and long distances as follows:

-  Top 3 men

-  Top 3 women

-  1st Veteran 40+ man

-  1st Veteran 40+ woman

-  1st Supervet 50+ man

-  1st Supervet 50+ woman

-  1st Relay Team

**Goodie bag for all competitors**

For more information please visit the event website; www.thornburyrunningclub.co.uk, contact Sandra Webber on 07778217962 or email

THORNBURY RUNNING CLUB AQUATHLON

Entry Form

Personal Details

Entrant 1 / Entrant 2 (Team Race entries only)
Name
Address
Postcode
Telephone Number: Day
Telephone Number: Evening
Email Address (Please write clearly)
Age at 31/12/11
Gender (please tick) / Male c Female c / Male c Female c
Name of Tri Club
British Triathlon Federation (BTF) membership number (if applicable)

All entrants at a BTF sanctioned event are required to have a BTF membership that will provide them with civil liability and personal accident cover whilst taking part in the event. If you are not a BTF member a day licence will be issued on the day of the event. The cost of this is covered in the entrance fee and on production of a current BTF card members will get £2 refunded on the day(£4 if entered as a team and both are members).

Race Categories
Distance you are entering (please tick) / Short – 500m Swim, 5k Run c
Long – 1000m Swim, 10k Run c
Estimated Swim time (Entries will not be accepted without a swim time) / ______
Please tick if you intend to do breaststroke c
Individual Race (please tick)
or / Open 18-39 c Veteran 40-49 c Super Vet 50+ c
Team Race / Team Name

Entrance Fee: Individual race £18 c Team race £22 a team c Please make cheques payable to Thornbury Running Club (For BTF members who produce their licence at the event £2 will be refunded).

I accept that this event is conducted under the rules & conditions of the BTF and I agree to acquaint myself with and abide by those rules and any instructions issued by the organisers or the support staff. I agree to details of my name & address being forwarded to the BTA for the sole purpose of registering me for the day licence. I declare that I am fit to take part in this event and understand that I take part entirely at my own risk. I accept that the event organisers & their associates are not liable for any injury, loss or damage sustained to either my person or property as a result of my participation.

Signed ______(Entrant 1) Signed______(Entrant 2)

Return to TRC Aquathlon, Sandra Webber, 7 Spencers Court, Alveston, Bristol, BS35 3BA

Data Protection: The information you provide will be stored for administrative purposes. All personal data will be held in accordance with the provisions of the Data Protection Act.

Please tick this box if you don’t want your details passed onto any 3rd party sponsoring this event c