childrenscancerrun.co.uk - High Spen Primary School

Report 15 Downloads 4 Views
Sponsored by

childrenscancerrun.co.uk

Raising funds for the North of England childrens Cancer Research fund.

Entry Form The 32nd Children’s Cancer Run Sunday 11th May 2014

First Name .............................................................................

Last Name ...........................................................................

Title ..........................................................................................

Date of Birth .......................................................................

Address............................................................................................................................................................................................ ............................................................................................................................................................................................................. .....................................................................................................

Postcode ..............................................................................

Email ................................................................................................................................................................................................ Are you participating (Please tick) Individually

As a school

As a team

5 mile

1 mile (under 7’s)

Team Name/School Name ..................................................................................................................................................... T-Shirt Sizes (Please tick) 26-28

30-32

34-36

38-40

42-44

46-48

I wish to enter the Greggs Children’s Cancer Run 2014. I understand that there is a possibility of injury as with any cross country run or event and I acknowledge that I am taking part at my own risk. Signed ................................................................................. For Children taking part under 16yrs: I consent for my child to take part in the Greggs Children’s Cancer Run 2014. There will be photos taken during the event which may be used in future for publicity materials, by signing this form you consent to these photos being used. His/Her age will be: ........................................................ on the 11th May. Signed: ................................................................................. I have enclosed a cheque for £ ................... Please make cheques payable to Childrens Cancer Run and include your name and address on the back of your cheque then return this form along with your entry fee to: Childrens Cancer Run, The Sir James Spence Institute for Child Health, RVI, Newcastle upon Tyne. NE1 4LP Demand for this years run is expected to be high, so please return this form as soon as possible. Entry fees are non returnable.

Entry fee – £6.00 (under 16) £12.00 (adults) Closing date for entry is Thursday 1st May 2014 or when entry limit is reached. Contact us at Email: childrenscancerrun.co.uk Tel: 0191 282 1322 or 07930 974 913 or enter on line at www.childrenscancerrun.co.uk