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UK Athletics, England Athletics and the Race Walking Association
jointly present the 2012 National 10mile Race Walking Championships
to be held under IAAF rulesSunday 4th March at the University Business Park, Coventry
starting at 1.30pmEntry Fee £10.00 to Peter Marlow Tel: 01284 754177
The Picture House, 134G Southgate Street, Bury St Edmunds, Suffolk. IP33 2AF
Cheques made payable to the Race Walking Association.Closing date for entries Monday 27th February
Changing and registration at Westwood Track, Coventry Godiva Clubhouse
Kirby Corner Road, Canley, Coventry, CV4 8EE
Please enter me for the following UKA Championship event to be held at University Business Park, Coventry, Sunday March 4th 2012.
Event _____________________________________________________________________
Name _______________________________________ Gender ____________________
Date of Birth ______/_______/_________
Address _________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Club____________________________________________________________________
County__________________________________________________________________
email:__________________________________________________________________
Telephone:_______________________________________________________________
Disclaimer: I acknowledge that the United Kingdom Athletics cannot be held responsible for any injury or loss sustained as a result of my participation in the event.
Signed ____________________________________________
Date ____________________________________________