UNIVERSAL RACE ENTRY FORM.

UNIVERSAL ROAD RACE ENTRY FORM.EVENT ENTERED?????????????????????????????.EVENT DATE ????????????????????NAME???????????????????????????????????ADDRESS?????????????????????????????????.?????????????????????????????????..???????????????????POST CODE?????????TELEPHONE NUMBER????????????????DATE OF BIRTH?????????........ AGE ON DATE OF EVENT???????..MALE / FEMALE???????????????.UK ATHLETICS CLUB????????????????????????????UKA REGISTRATION NUMBER??????????????????.T. SHIRT SIZE ( If applicable) S???? M???.. L????. XL????.ENTRY FEE ENCLOSED UKA £??????? UA £???????..PLEASE ENCLOSE SAE FOR NUMBER AND EVENT DETAILS.I DECLARE THAT I AM AN AMATEUR AS DEFINED BY UK ATHLETICS.I AM MEDICALLY FIT TO PARTICIPATE IN THIS EVENT, AND I UNDERSTAND THAT THE ORGANISERS OF THE EVENT WILL IN NO WAY BE HELD RESPONSIBLE FOR ANY INJURY, LOSS OR DAMAGE TO MYSELF, OR MY PROPERTY.SIGNED??????????????????? DATE??????????.