<p> Entry Form for Wessex League 2014-2015</p><p>Please complete all white sections - write clearly and in BLOCK CAPITAL letters. </p><p>Section 1: To be completed by participant:</p><p>SURNAME: SECTION 2: To be completed by race administrator:</p><p>RACE FIRST NAME: NUMBER:</p><p>DATE OF BIRTH: dd/mm/yy</p><p>GENDER Please circle MALE / FEMALE</p><p>UKA ATHLETICS CLUB</p><p>Race Administrator use only:</p><p>Transfer information to First Aider MEDICAL information sheet CONDITIONS: YES / NO</p><p>FEE PAID: N/A Race Administrator use only:</p><p>ADDRESS:</p><p>POSTCODE:</p><p>EMAIL: PHONE:</p><p>I have read the conditions of race entry. (Displayed on side of marquee) and agree to read and complete reverse of my number. </p><p>SIGNATURE: DATE:</p><p>Forms to be returned one week before the first fixture via post to Lindsay Hole, 10 Meadowsweet Road, Creekmoor, Poole, Dorset BH17 7XT.</p>