Gloucester 10k
Sunday 12th July 2015 in GloucesterPark, 9.00 am
This year the Rugby World Cup comes to Gloucester. To celebrate this we have added a rugby theme to the Gloucester 10k and are inviting rugby clubs to enter their own teams as a bit of friendly rivalry and gain bragging rights ahead of the new season! Come on, you know you want to! Support the Gloucester community by persuading your team mates to enter the Festival of Rugby - Rugby Club 10k Challenge.
- Teams of 4 to 6 runners required (each Club can enter as many teams as it wishes) plus the cost is the same as if a runner enters the race individually.
- There is a prize and trophy for the first team and prizes for the first male and first female running for a company team.
- All runners will receive a goody bag including a technical T-shirt, medal and some goodies!
- All proceeds to local charities.
Complete the attached entry form, follow the instructions and then get ready to run!
Go to the race website for more details of the run.
Entry Form
Please complete and send to:
Amanda Bell, Gloucester 10k,
Davies and Partners, Rowan House,
Barnett Way, Barnwood, Gloucester, GL4 3RT
With a relevant cheque made payable to:
Davies and Partners (Gloucester 10k)
Alternatively email the form to then phone Amanda on 01452 612345 to pay by debit card.
Cost: £16 per each UK Athletics Affiliated Club Runner
£18 for each non-UK Athletics Affiliated Club Runner
Team Captain’s details:
Full name: Date of birth:
Daytime contact number: Mobile number:
Gender: Male/Female
Email address:
Name and Postal address of business:
Relationship to the Club (e.g. Chairman/Coach/Player):
Team Name:
Are you affiliated to a UK Athletics Club: Yes/No
If so which club:
Technical T-Shirt size: S, M, L, XL
Disclaimer:- I am an amateur as defined by UK Athletics and will abide by the race rules and the Rugby Club Challenge rules. I am physically fit to run and understand that I enter at my own risk. I agree that the organisers shall not be liable for any accidents, injury, loss or damage caused as a result of my participation.
Signature:
Date:
Second Entrant’s details:
Full name: Date of birth:
Daytime contact number: Mobile number:
Gender: Male/Female
Email address:
Relationship to the Club (e.g. Chairman/Coach/Player):
Are you affiliated to a UK Athletics Club: Yes/No
If so which club:
Technical T-Shirt size: S, M, L, XL
Disclaimer: I am an amateur as defined by UK Athletics and will abide by the race rules and the Rugby Club Challenge rules. I am physically fit to run and understand that I enter at my own risk. I agree that the organisers shall not be liable for any accidents, injury, loss or damage caused as a result of my participation.
Signature: Date:
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Third Entrant’s Details:
Full name: Date of birth:
Daytime contact number: Mobile number:
Gender: Male/Female
Email address:
Relationship to the Club (e.g. Chairman/Coach/Player):
Are you affiliated to a UK Athletics Club: Yes/No
If so which club:
Technical T-Shirt size: S, M, L, XL
Disclaimer:- I am an amateur as defined by UK Athletics and will abide by the race rules and the Rugby Club Challenge rules. I am physically fit to run and understand that I enter at my own risk. I agree that the organisers shall not be liable for any accidents, injury, loss or damage caused as a result of my participation.
Signature: Date:
Fourth Entrant’s details:
Full name: Date of birth:
Daytime contact number: Mobile number:
Gender: Male/Female
Email address:
Relationship to the Club (e.g. Chairman/Coach/Player):
Are you affiliated to a UK Athletics Club: Yes/No
If so which club:
Technical T-Shirt size: S, M, L, XL
Disclaimer:- I am an amateur as defined by UK Athletics and will abide by the race rules and the Rugby Club Challenge rules. I am physically fit to run and understand that I enter at my own risk. I agree that the organisers shall not be liable for any accidents, injury, loss or damage caused as a result of my participation.
Signature: Date:
------
Fifth Entrant’s details:
Full name: Date of birth:
Daytime contact number: Mobile number:
Gender: Male/Female
Email address:
Relationship to the Club (e.g. Chairman/Coach/Player):
Are you affiliated to a UK Athletics Club: Yes/No
If so which club:
Technical T-Shirt size: S, M, L, XL
Disclaimer:- I am an amateur as defined by UK Athletics and will abide by the race rules and the Rugby Club Challenge rules. I am physically fit to run and understand that I enter at my own risk. I agree that the organisers shall not be liable for any accidents, injury, loss or damage caused as a result of my participation.
Signature: Date:
Sixth Entrant’s details:
Full name: Date of birth:
Daytime contact number: Mobile number:
Gender: Male/Female
Email address:
Relationship to the Club (e.g. Chairman/Coach/Player):
Are you affiliated to a UK Athletics Club: Yes/No
If so which club:
Technical T-Shirt size: S, M, L, XL
Disclaimer:- I am an amateur as defined by UK Athletics and will abide by the race rules and the Rugby Club Challenge rules. I am physically fit to run and understand that I enter at my own risk. I agree that the organisers shall not be liable for any accidents, injury, loss or damage caused as a result of my participation.
Signature: Date:
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I certify that I have read the rules applying to the Festival of Rugby – Rugby Club 10k Challenge and that the team meets the eligibility criteria.
Signed:
Dated:
Please remember to enclose a cheque with your entry (£16.00 per affiliated runner and £18 per non-affiliated runner)