Brinsworth 10K Run enter the race

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Entries are £12 for the Run with all proceeds going to Weston Park Cancer Charity

To enter the race please complete the form to the right. You can then either send a cheque or cash to

35 Croft Road, Brinsworth, S60 5AP with a stamped address envelope so we can send your number. Alternatively you can collect your number from the above address.

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First Name
Last Name
Sex
email address
Age On Race Day
Address
City
Postcode
Phone
Payment Type
T Shirt size
	By ticking this box I agree that I will not hold the organisers or any other person responsible for any injury or illness resulting from the event.