ASTRATECH JOHN RUDD MEMORIAL RACE SERIES
(in association with the TOUR DE FRANCE)

ENTRY FORM

Personal data:

Surname/family name:

Sex:

 Male     Female  

Country:

Address:

Postcode/Zip:

Date of birth:

( dd-mm-yyyy)

Telephone:

Mobile:

E-mail:

Do you require transport to/from airport?:

Flight details:

Flight number airport:

Arrival time:

Departure:

T-shirt size:

XL     X    M    S

Division:

Men

Division A1 (C1-C5)(equivalent Track and Field T51)

Division A2 (C6-C8)(equivalent Track and Field T52)

Division B (T1-T10)

Division C1 (T11-L5)(LONGSEAT) Amputees and others

Division C2 (KNEESEAT) Double amputees and others

Women

Division FA

Division FB (T1-T10)

Division FC (T11-L5)

Disclaimer

I accept all the conditions of entry overleaf and acknowledge that the organisers shall not be liable for death, personal injury, loss or damage as a consequence of my participation in the ASTRATECH JOHN RUDD MEMORIAL RACE SERIES 2007.

I accept