Race Calendar

Jane Tomlinson Canal Race Series RACE 2

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.

Team Name:

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:

Charitable Donations

Rothwell Harriers AC is fundraising for Jane Tomlinson Appeal https://www.janetomlinsonappeal.com/. If you would like to make an additional donation to Jane Tomlinson Appeal https://www.janetomlinsonappeal.com/, please enter an amount next to the chosen charity.

Donation to Jane Tomlinson Appeal https://www.janetomlinsonappeal.com/:

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.

Team Name:

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: