Polesden Lacey 10K Sunday 24Th June 2012, 9.30Am NEW EVENT for 2012

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EVENTS TO LIVE Polesden Lacey 10k Sunday 24th June 2012, 9.30am NEW EVENT FOR 2012 Polesden Lacey is a beautiful 1,400 acre estate with stunning views across the Surrey Hills. It was owned from 1906 by the famous Edwardian hostess, Mrs Greville, who entertained royalty, politicians and the cream of society here. Entrants, family and friends coming to support receive free entry into the grounds. The race HQ is Polesden Lacey, Great Bookham nr Dorking, RH5 6BD. Starting and finishing in the grounds, it is a scenic and undulating course. Race memento for all finishers. The charity beneficiary is the National Trust. More details at www.eventstolive.co.uk Entry Fees: Send entries to: Entrants must be 16 years or over: Polesden Lacey 10k Entry price: £15 c/o Run to Live Cheques payable to ETL Events Ltd. 200 Barnett Wood Lane th Ashtead Closing date for postal entries is 12 June 2012 More details on www.eventstolive.co.uk Surrey KT21 2DB Entry form, please print legibly: First name:________________________ Surname:___________________________ Address:__________________________________ Date of Birth: _______________ _________________________________________ Male/Female: _______________ Town:____________________________________ Home No: __________________ County:___________________________________ Mobile: ____________________ Postcode: ____________________________________________________________ E-mail: ______________________________________________________________ Club: ________________________________________________________________ I agree to abide by the rules of England Athletics. I accept that neither the organizing committee, their servants, agents or assignees will be held responsible for any loss, damage or injury, howsoever caused, sustained by myself or any other participant prior to, during or after this event and expressly waive the right to pursue any of the above or make any claim against the event. I understand that the organizers reserve the right to alter conditions or arrangements should the circumstances require. I confirm that I am an amateur as defined by the England Athletics rules. Personal information will be dealt with in accordance with the Data Protection Act. I understand that photographs will be taken and may be used for promotional use in the media or websites. I acknowledge that the use of mp3 players/headphones during the race is banned and I will be disqualified if I am seen to use them. Signed: ____________________________________ Date: ___________________ .

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