The Sedgefield Serpentine Race will take place on Sunday 11September 2011 at 10:30am

A scenic and undulating off-road route of approximately 6.5 miles on beautiful paths around Hardwick Park and Bishop Middleham

Start & Registration: Sedgefield Cricket Club, Station Road, Sedgefield, TS21 2BY

Followed by a Barbeque in the club grounds – family and friends welcome

Cheques payable to: Sedgefield Harriers Entrants must be 16 yrs or over

Send to: Matthew Jones
11 Hawthorn Terrace
Bishop Middleham
Co. Durham DL17 9AX

Closing date for postal entries is 4th September 2011. Entry fee is Non Refundable.

PLEASE ENCLOSE AN SAE WITH YOUR CHEQUE
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Entry Form

Surname………………………………………….Forename……………………………………………DOB…….. /……. /……………

Address……………………………………………………………………………………………………………………………………..

………………………………………………………………………………………………Postcode……………………………..……..

Email………………………………………………………………….………………Telephone………….……………………………..
Are you: Male □ Female □ Age on race day……………..
Are you a member of an affiliated athletics club? Yes □ No □

If YES, name of club………………………………………………………………………Registration No………………….…………..

Declaration:
I wish to take part in the 2011 Sedgefield Serpentine Race and declare that I am 16 years old or over. I certify that organisers will not be held responsible for any loss, damage or injury incurred to my person during or as a result of taking part in this race.

Signed……………………………………………………………………………Date……………………………………………………

For Official Use Only: Race Number……………………..Category……………………………..Fee Paid……………….

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