Northern Ireland Mountain Running Association
www.nimra.org.uk
Hill & Dale 2011 Registration Form
Hill and Dale Race Series Entry Form 2011
Promoted by Newcastle AC (www.newcastleac.org) Race Number_______ (Official use only)
Full Name (Print)_____________________________________________________
Address_____________________________________________________________
____________________________________________________________________
Phone No__________________________ Date of Birth____________________
ANI Affiliated Club - YES or NO
Next of Kin _____________________ Telephone Number____________________
Email __________________________________________________________________________
Car Registration _______________________________________
Qualified First Aider Yes or No (Please circle appropriately)
Category (Tick below as appropriate)
Male Junior _____ Open _____V35_____V40_____V45_____V50______V55_____V60____
Female Junior____ Open ____LV35____LV40____LV45____LV50____LV55____LV60____
Entry Prices
Seniors: Athletics NI registered athletes – £7.00
Non-registered/Unattached/ Non ANI Affiliated clubs - £8.00
Juniors:- £3
Attention is drawn to the following points
- Numbers and pins must be returned after each race or result will not be recorded.
- A Charge will be made for re-issue of lost number.
- Only one form is required to be completed for entire race series
- Non finishers must report to the Start Offical before leaving the race.
- Safety equipment required for mountain races (compass, whistle, full body cover) please get in the habit of bringing these to every race
- Navigation skills required on mountain races.
- Car sharing should be used for all races.
I understand the H&D Race series is held in accordance with the rules and safety requirements of NIMRA. I am aware of the organiser’s information and requirements in connection with the race series. I accept the hazards involved in mountain running and acknowledge that I am entering and running each race at my own risk, other than the organiser’s liability for causing death or personal injury by negligence. I confirm that I understand that the organiser accepts no liability to me for any loss or damage of any nature to myself or my property arising out of my participation in the race series.
Signed_______________________________________________ Date_______________
Copyright © 2012 NIMRA or as otherwise stated.
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