Wallington 10k Road Race & Family Fun Run Wallington, Cambo, Northumberland Sunday 12th Sept. 2010 Race Starts at 10.00am (Mile at 10.15am) 10km road race from historic Wallington, along the River Wansbeck, through Scots Gap & Cambo. A scenic route through the heart of rural Northumberland. Parking/cafe/toilets are available at Wallington (free entry to gardens/grounds to all runners) (please note the limit is 350 in the first year) UNDER UKA RULES - PERMIT 2010-100757 Vouchers, Prizes and Medals to be awarded in the following age groups:- MALE - 1st 3 overall, U20, M35, M40, M45, M50, M55, M60+ Team - 1st 3 runners to score FEMALE - 1st 3 overall, U20, W35, W40, W45, W50, W55, W60+ Team - 1st 3 runners to score Team Categories 1) UKA affiliated clubs 2) Corporate Teams 3) Northumbrian Community Teams (community teams represent a village or town in Northumberland) CLOSING DATE Wed 1st Sept 2010 VISIT THE RACE WEBSITE www.wallington10k.org.uk In partnership with WALLINGTON 10K Sunday 12th September 2010 ENTRY FORM 10k Race Mile Run (tick one) PARTICIPANT DETAILS Affiliation & Entry Fee Runners name: UKA Affiliation No: Date of Birth: Age on 12th UKA Club: Sept: (10k Min 16yrs old ) Male or Female: Any medical conditions/medication taken: Address: 10K Entry Fee £10 (UKA affiliated athletes) £12 (unaffiliated runners) Postcode: Mile Entry Fee £5 (under 16’s only) Please make cheque payable to “Team Decathlon” and return with entry form to: Team Decathlon, PO Box Email: 1124, Newcastle upon Tyne, NE99 2XN Tel: or debit my card (plus £1 processing fee) CARD PAYMENTS - Visa/Mastercard (delete one) Community or Corporate Teams: Corporate / Community / circle one Start Date / Exp Date / Team Name:.................................................. Security No. Signature ........................... This signed entry form constitutes a declaration that I E: [email protected] will take part in the event entirely at my own risk, that I W: www.wallington10k.org.uk have no medical conditions that may endanger me or T: 07545 140 810 other participants, and that I remain personally responsible for my own property at the race venue. As If you would like information about Run Northumberland a 10K entrant I am aged 16 years or above. please tick here . If you would not like to know about future events tick here . Photographs may be taken Signed (parent/carer if Under 18): during the race for publicity and the website. If you do not want your son/daughter to appear tick here Entry Conditions 1. Payment must be made no later than 14 days before the Print Name: race. 2. Refunds cannot be made for cancelations after the closing date of the race. Date: 3. Venator International Ltd and Team Decathlon and our staff will not be responsible for loss or additional expenses incurred Team Decathlon AC is in partnership with Venator by any participant or their parent/carer due to injury or sickness International Ltd, Company Registered in England whilst at the event due to weather, strikes, war or any other No. 06871003 causes which were out of their control..