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EvenSplits Lockdown League
About You
First Name:
Last Name:
Date Of Birth:
Gender:
Male
Female
Non-binary
Is Wheelchair Entry:
Non-wheelchair entry
Wheelchair entry
Contact Details
Contact Telephone:
Email:
Address Line 1:
Address Line 2:
City:
Postcode:
Entry Details
Entry Type:
£15.00 - League races only
£20.00 - League race + STAY THE DISTANCE buff
£25.00 - League races + STAY THE DISTANCE t-shirt
£30.00 - League race + STAY THE DISTANCE t-shirt and buff
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.
If you have chosen an entry fee that includes a t-shirt, then write your size and colour here:
Additional Information:
Team Mate
First Name:
Last Name:
Date Of Birth:
Gender:
Male
Female
Non-binary
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First Name:
Last Name:
Date Of Birth:
Gender:
Male
Female
Non-binary
Is Wheelchair Entry:
Non-wheelchair entry
Wheelchair entry
Contact Details
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Contact Telephone:
Email:
Address Line 1:
Address Line 2:
City:
Postcode:
Entry Details
Entry Type:
£15.00 - League races only
£20.00 - League race + STAY THE DISTANCE buff
£25.00 - League races + STAY THE DISTANCE t-shirt
£30.00 - League race + STAY THE DISTANCE t-shirt and buff
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.
If you have chosen an entry fee that includes a t-shirt, then write your size and colour here:
Additional Information:
Team Mate
First Name:
Last Name:
Date Of Birth:
Gender:
Male
Female
Non-binary
Add another entrant
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