race entry form

Data Protection Act
The information you provide will be held by
our race administrator, FR Systems, and then
passed to Bristol City Council and UKA. If you
require access to the personal data Bristol
City Council holds on you, please contact the
Data Protection Officer, The City Hall,
College Green, Bristol, BS99 7PH, in writing.
Race Information and other details
Race organisers Bristol City Council, would
like to offer a more efficient service and
become more environmentally friendly by
reducing the amount of printed matter we
produce. Instead of sending you information
by post, we would like runners to download
race information from our website. We will
also notify you by email or text when new
information is available on our website that
we would like you to read.
Please tick here if you are happy to be updated
by email by text
Please tick here if you can only
accept information by post
runbristol training and advice
During 2013 runbristol will be offering advice
and practical training sessions for runners of
all abilities.
Please tick here if you wish to be contacted
by:
email text post
An official photographer will take photos of
all runners finishing the race. If you would
like to be contacted about purchasing a
photograph of yourself, please tick here:
If you are happy for your name to be passed to
our official sponsors who may wish to contact
you regarding special offers or promotions,
please tick here:
If you are happy to be contacted by race
organisers Bristol City Council regarding
future sport activities, please tick here:
Declaration
I agree to abide by UKA rules. I am
medically fit to participate in the event and
understand that I enter at my own risk and
that the organisers and associated partners
shall not be held responsible for any injury
or illness that may be caused to myself as a
result of the event, or for any property lost
during the event. I also agree to notify the
race organisers on 01782 396113 prior to
the event if my situation changes. I agree
to write my emergency name and contact
details for race day and any medical
conditions which the race organisers should
be aware of, on the reverse of my number.
I also agree to pay £10 if I do not return
my ChampionChip within 30 days after the
race.
Signature
Date
Cheques payable to:
Bristol City Council (Bristol 10k), please
write your name and address on the back.
Important
Please ensure that you have completed ALL
parts of the form and that your details are
correct. Send the completed signed entry
form and your cheque or postal order for
your race fee to the race administration
agency:
RunBristol 2013,
FR Systems,
PO Box 512,
Cheadle,
Stoke-on-Trent ST10 4RJ
Tel: 01782 396113
email: bristol@frsystems.co.uk
Bristol Design, Bristol City Council BD3548
SUNDAY 5 MAY 2013 BRISTOL HARBOURSIDE 9.30am
(Bank Holiday weekend)
Minimum age 15 years on race day
Suitable for experienced racing wheelchair athletes
Free t-shirt to all finishers
Course accurately measured
Km markers
No late entries
No entries on the day
Organised under UKA rules
race entry form
www.runbristol.com

Race distance: 10km
Race limit: 15,000
Licence: UKA Licence number tbc
Closing date for receipt of entries: Monday 8 April
2013 or sooner if the race is full. As demand will be high
please enter as early as possible to avoid disappointment.
Entry fee:
If a member of UKA affiliated running club: £22**
If not a member of UKA affiliated running club: £24
£14 over 60 on race day (proof of age may be required,
and if not provided the organisers reserve the right
to declare the entry void. Any entry fee paid will be
retained to cover administration costs).
PLEASE NOTE: Please think carefully before entering as
entry fees are not refundable and places in the race are
non-transferable.
How to apply
Priority on-line entry:
Enter on-line (credit / debit card payment).
Your place will be allocated and confirmed
by email immediately. Please note there will
be an on-line processing fee of £3. If you
wish to apply on-line, please visit the race
website at: www.runbristol.com
ENTRY FORM
SUNDAY 5 MAY 2013
(Bank Holiday weekend)
BRISTOL HARBOURSIDE
race start: 9.30am
Business Challenge:
Companies are invited to
enter teams in the Business
Challenge. For more information
visit the race website:
www.runbristol.com
**Club Athlete Special Offers:
In a move to encourage more
UKA affiliated clubs to take part,
race organisers are offering
special rates for group bookings
by UKA affiliated clubs. Details
of how to apply for this can be
found on our website at:
www.runbristol.com
Or you may complete this form:
If you wish to enter by post please
ensure you complete all sections of this
form and enclose payment by cheque or
postal order (no cash payments please).
Entries will be allocated on a “first come
first served basis” and confirmation sent.
Entries received with no payment, or
rejected payment, will not be accepted.
www.runbristol.com
2013 BRISTOL 10k ENTRY FORM (all in capitals please)
Surname
First name(s)
Address
Home phone:
Work phone:
Mobile:
email:
Postcode
Date of birth / /
Age on race day
Are you...? Male Female
Nationality
Are you a member of UKA affiliated
running club or association?
Yes No
Name of club
If no, are you running as part of a team?
Name of team
Yes
No
Team prizes (where applicable) will be
awarded as follows:
First 4 runners in men’s teams.
First 3 runners in women’s teams.
Are you an individual athlete?
Are you a Wheelchair Athlete?
Are you eligible for the runbristol British
Prize Awards**? Yes No
UKA / England membership number:
** “British” refers to British Passport holders who
are eligible to compete for Great Britain and
N. Ireland (as confirmed by UKA). The organisers
reserve the right to request proof of nationality
and eligibility. Participants failing to complete
this section will NOT be included in the awards.
What is your personal best 10k time in
the last two years?
At which event?
Estimated finishing time for this race:
Medical information / Emergencies
Name of person to contact on race day:
Their Phone Number:
If you have a medical condition please
notify the race organisers on
01782 396113 prior to the event and
ensure that you provide the information
required on the back of your race number.
Race souvenir T-shirt
Please circle the size you would like:
S M L XL
34-36 38-40 42-44 46-48
Official Race Charities
If you would like to receive a fundraising
pack from our official charities please tick
below. Information about the charities is
available on our website at: runbristol.com
Wallace & Gromit Coco
CLIC Sargent
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