NY FROLIC 2015 ENTRY FORM

NY FROLIC 2015 ENTRY FORM

Post to : Ian Brazier 23 Jarvis Field, Little Baddow, Essex CM3 4TP

Enclose entry fee with cheque payable to : Ian Brazier

BLOCK CAPITALS PLEASE

NAME:

ADDRESS:

PHONE No:

CLUB/GROUP:

Over 18?:

SIGNATURE:

MALE/FEMALE

FULL / SHORT COURSE

E-MAIL ADDRESS ( If acknowledgement of entry is required) 

Please enter me for the NY Frolic. I understand that I enter at my own risk and that the organisers cannot be held responsible for any injury sustained by myself, or for any property lost by me during the event.

TRA permit  RA / 38-15