Organisedby the Llanishen
Rotary Club

2012 CARDIFF FUN RUN
APPLICATION FORM

Please complete and send this form, together with
a cheque for your entry fee to the

Cardiff Fun Run
Llanishen Good Neighbours
4 Heol Hir
Llanishen
Cardiff
CF14 5AE

Cheques payable to “Cardiff Llanishen Rotary Fun Run Group”

Runner Forename
 

Runner Surname

Gender

Age Group
(for prize allocation)

Address
 

Postcode
 

Email

Runner Type
(delete as appropriate)

Wheelchair Race

Charity/Team Name
(if appropriate)

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Male / Female    (delete as appropriate)

Under 18       .............      18-59yrs    .............            60yrs or over       ............



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.................................................              Telephone         ........................................


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AFFILIATED RUNNER (Affiliated to UK Athletics)/NON AFFILIATED RUNNER
 
Will you be entering the wheelchair race?  Yes / No (delete as appropriate)

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ENTRY FEE

£10 FOR EACH PARTICIPANT