hotelympia10k.com : 26th February 2012 - ExCeL London

Hotelympia10k Race Entry Form

Registrations for the 2012 race are now open.

Closing Date: Sunday 19th February 2012 (race limit is 2012 runners).

Please note: ALL race entrants need to submit a race entry form and pay for entries individually as the declaration forms part of our insurance. The entry fee is £13 UKA Affiliated, £15 Non UKA Affiliated. No refunds can be made after payment is complete.

* First Name:
* Surname:
* Email Address:
Age on 26th February 2012:	(UKA minimum age for 10km race is 15 years)
* Date of Birth:	(DD/MM/YYYY)
* Address:
Town:
County:
* Postcode:
Contact Number:
Company:
Job Title:

* UKA Affiliated Club Member:
If yes, which club:

Expected Distance Time:	hrs : mins
Your T-Shirt size:
Individual Categories:

How did you hear about this event?	Springboard Leapfrog Hotelympia Other :
Team Information:
Are you running as part of a team?	Yes No
If yes, team name:
Company:
Company Address:
Town:
County:
Postcode:
** Gift Aid: Yes
Declaration: Please tick this box. By submitting this form I confirm that I am medically fit and understand that I enter at my own risk. The organisers will not be held responsible for any injury or illness caused to me during or as a result of the race, or for any property lost during the event. The organisers reserve the right to alter the date of the event or to change the published course as deemed necessary at any time. I declare I will abide by the rules of UK Athletics, I am an amateur as defined by the UK Athletics Rules and Regulations and I will be 15 years or over on the day of the event. You may use my name, voice or picture for PR or event promotion. No refunds can be made after payment is complete.

* indicates required field
** Gift Aid: An element of the Race Entry Fee includes a donation to The Springboard Charity, a charity that helps young, unemployed and disadvantaged people improve their chances in life by providing information and advice, skills development opportunities and work experience throughout the hospitality industry and at the same time helping the industry address its severe skills shortage. The Springboard Charity can claim at least 28% on every donation, without it costing you a penny extra. If you are a UK tax payer please tick the box to indicate that you would like us to Gift Aid your donation. This supports our tax claim and will not be used to contact you if you would prefer us not to. Please be aware that you must have paid an amount of income and/or capital gains tax at least equal to the Gift Aid we recover on your donation in the tax year you make the donation.