WOULD YOU LIKE TO REPRESENT TOWER HAMLETSIN THE LONDON MINI MARATHON?

This year'sVIRGIN MONEY GIVING MINI LONDON MARATHONtakes place on Sunday 22ndApril 2018

ORGANISED BY TOWER HAMLETS SPORTS & PHYSICAL ACTIVITYTEAM in partnership with

Mile End Junior Parkrun Victoria Park Harriers and Tower Hamlets Athletics Club

TRIALS TAKE PLACE ON:

SUNDAY 18thMARCH 2018

AT MILE END STADIUM RHODESWELL ROAD E14 7TW (E3 4RR)

REGISTRATION –9.00am - RACE TIME- 9.30am – 11 – 13 year olds

10.00am- 14- 17 year olds

THE AGE YOU WILL BE ON 22NDAPRIL 2018

RACE 1 / Under 13 Boys & Girls / Must be at least 11 years old on 22nd April 2018
Born between
(1st September 2004and 21stApril 2007
RACE 2 / Under 15 Boys & Girls
Under 17 Boys & Girls / Born between
(1st September 2002 and 31st August 2004)
Born between
(23rd April 2000 and 31st August 2002)

N.B Closing date for applications Wednesday 14th March 2018

If you would like to enter the trials to take part in this world renowned event, please complete and return the form below:

PLEASE TURN OVER FOR APPLICATION FORM

VIRGIN MONEY GIVING MINI LONDON MARATHON TRIALS 2018 ENTRY FORM

SURNAME:………………………………………………FIRST NAME …………………………………………………………

ADDRESS: ……………………………………………………………………………………………………………………………..

……………………………………………………………………POST CODE………………………………………………………

HOME TELEPHONE:…………………………………………COMPETITORS MOBILE:…………………………………………

EMERGENCY NUMBER:……………………………………………………………………………………………………………..

SCHOOL:………………….……………………………………………………………

PARENTS/GUARDIANSE- MAIL ………………………………………………………….

COMPETITIORS E- MAIL …………………………………………………………………..

AGE ON 22ndAPRIL 2018: (Must be 11 by this date) ………………………………… D.O.B……………………………………

MALE/FEMALE………………………………………………..… ETHNICITY ……………………………………………………

HAVE YOU A MEDICAL CONDITION? Please state ……………………………………………………………………………

PHOTOGRAPHS

I am aware that photographs may be taken during the trials for promotional purposes and give my consent

for my child to feature in such photos

YES / / NO / /
Please tick

SIGNATURE OF PARENT/ GUARDIAN …………………………………………………………………………………………

Late entries will be accepted but only with prior agreement

PLEASE RETURN ENTRY FORM TO:

Or

Shenneth Brereton – Sports Development Officer

Mulberry Place

5 Clove Crescent

London

E14 2BG