Race Calendar

Leeds Country Way Winter Ultras

About You

First Name:

Last Name:

Date Of Birth:

Gender:

T-Shirt size:

Contact Details

Contact Telephone:

Email:

Address:

Address Line 1:

Address Line 2:

City:

Postcode:

Entry Details

Entry Type:

Affiliated Club:

Registration Number:

This club name has not been recognised. Only proceed if you are sure the name is correct and that your club is affiliated to your sport’s governing body.

Expected Finish Time (HH:MM:SS):

You will need to confirm that you have the experience necessary to complete the course. In the box below please give ONE EXAMPLE of a marathon or ultra marathon event you have completed in the last 2 years.:

Contact in Case of Emergency:

Phone in Case of Emergency:

Additional Information:

Team Member

First Name:

Last Name:

Date Of Birth:

Gender:

Charitable Donations

Great Owl Running is fundraising for MNDA - Motor Neurone Disease Association. If you would like to make an additional donation to MNDA - Motor Neurone Disease Association, please enter an amount next to the chosen charity.

Donation to MNDA - Motor Neurone Disease Association:

Please treat my donation(s) as a Gift Aid donation.

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for the current tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities and Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for the current tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I have given.

About Entrant _1

First Name:

Last Name:

Date Of Birth:

Gender:

T-Shirt size:

Contact Details

Contact Telephone:

Email:

Address:

Address Line 1:

Address Line 2:

City:

Postcode:

Entry Details

Entry Type:

Affiliated Club:

Registration Number:

This club name has not been recognised. Only proceed if you are sure the name is correct and that your club is affiliated to your sport’s governing body.

Expected Finish Time (HH:MM:SS):

Contact in Case of Emergency:

Phone in Case of Emergency:

Additional Information:

Team Member

First Name:

Last Name:

Date Of Birth:

Gender: