Enter online at:
www.5kchallenges.org.uk or complete the form below 2011 ENTRY FORM
Event(s) entering Aberdeen, Wednesday 8th June Inverness,Wednesday 15th June Borders, Tuesday 21st June Glasgow, Wednesday 22nd June Edinburgh, Tuesday 28th June Run 1 – 6pm Edinburgh, Tuesday 28th June Run 2 – 7.30pm Dundee,Wednesday 29th June
Personal Details Title First name Surname
Male Female
Address Postcode Daytime Phone Email Date of Birth (must be 11 or over on the day of the run)
What’s your Challenge? Tell us your story of why you are taking part and you will be entered into a prize draw to win Run 4 It vouchers
Team Challenge Are you part of a team/club?
What type of team? Workplace Team Community Team scottishathletics Club
Team Name (To ensure you are placed in the correct team please use the exact name as others in your team)
Have you run a 5k before? Yes No
Entry fees per challenge jogscotland Gold /scottishathletics member £10
Membership number
All others £12 Total amount payable
Payment Details Cheque
(please make cheques payable to Scottish Athletics Ltd.)
Credit/Debit card Card Type Card Number Start Date Expiry Date Issue Number (if applicable) Security Code (last 3 digits on signature strip)
Entry closing dates Entries by post will close seven days before each event. Please send to jogscotland challenges, PO BOX 12388, Edinburgh, EH11 4YH. Entries by telephone will close seven days before each event. Please call 0131 273 3003. Online entry will remain open until the day before each event, unless the event limit has been reached.
Race packs and timing chips Your running number and your timing chip must be collected on the night of the event, collection points will open two hours before the start of each run and will close 15 minutes before the start, you must allow sufficient time to collect your number and timing chip as without these you will not be able to take part. Detailed information about each event, including directions and timings, can be found at the website
atwww.5kchallenges.org.uk.
Free jogscotland membership This will entitle you to a free quarterly Stride magazine, free annual Stride logbook and various discounts on running related products and services: Yes please, sign me up
Thanks, but I am already a member No thanks, not just now
Declaration By signing this entry form I confirm my wish to enter the 5k challenge(s) and agree that I will be bound by the terms and conditions of the event (available on request) and UK Athletics rules. I confirm that I am taking part in the event at my own risk and acknowledge that, to the extent permitted by the Unfair Contract Terms Act 1977, the organisers are not responsible for death, personal injury or any losses or damage arising from participation or as a consequence of participation in the event. I understand that official photographers will be in attendance at the event and that my image may be used in future marketing and/or PR. Signed:
Parent or Guardian if under 16 Return to: jogscotland challenges, PO Box 12388, Edinburgh, EH11 4YH Email:
jogscotland@scottishathletics.org.uk Tel: 0131 273 3003
www.5kchallenges.org.uk
Yes No
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