04/06/08     02/07/08     30/07/08

PERMITS 10214/10215/10452

START 19.30     AT BROOME VILLAGE HALL, NEAR BUNGAY, SUFFOLK

First Name:

Surname:

Sex:   Male    Female

Date of Birth:   (Participants must be at least age 15 on race day)

Address:

Town:

County:

Post Code:

Email:

Club:

Telephone:    (Inc area code)

Please Indicate Category Entered:

Please Indicate Race(s) Entered:
(tick all appropriate boxes, eg if entering all 3 races, please tick all boxes)

Race 1 (04/06/08)
Race 2 (02/07/08)
Race 3 (30/07/08)