Online Entry

Race: (Please Select)
Please Select RaceLongridge 7 Affiliated Runner £9Longridge 7 Unattatched £11

First Name:

Surname:

Address: (inc. postcode)

Date Of Birth: (DD / MM / YYYY)
  /    /  

Male Female

Club Name: (If  Attached)

E-Mail:

Phone No: (no spaces)


I declare that I am an Amateur as defined by British Athletic Federation Rules.
I certify that I am fit to run.
I understand that the organisers will in no way be held responsible for either my injury, illness or property during the event.