Entry Form For

The Durham Dales Challenge
Please complete the form below and send it by post to:


Bob Shuttle

68 Acomb Crescent

Newcastle-upon-Tyne

NE3 2BB

or click on the send button.



First name and Surname Address Postcode and Telephone No:
Age:
Female/Male:
Walker/Runner:    
   
Please send the entry fee of £5(cheque/postal order) No Cash: to Bob Shuttle at the above address and made payable to the NORTHUMBRIA LONG DISTANCE WALKERS ASSOCIATION:
   
I agree to follow the Country Code and the rules of the event. I accept that the organisers cannot be held responsible for any accident or mishap sastaind by me during this event.If the entry is by post, please send a stamped address envelope 9x4 for confirmation of your entry and number and directions to the start point if by e-mail on confirmation of payment you will be e-mail back with a number and start details


If you would like a results sheet. send a second SAE 9X4


DATA PROTECTTION ACT:All entrant's details will be held temporarily in an electronic retrieval system to be used only for the purpose of administering the event


Please state if you would like a vegetarian meal:


Yes/No:
Please state if this is your 10th DDC: 
Yes/No:
Full Name and Date:
       
            
                Home    Top