Stratford's Big 10k

Date 9-SEP-2018
£17-19 +service fee

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1
ACCOUNT DETAILS
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2
ENTRY DETAILS
* Address 1
e.g. 99 Stanley Terrace
Address 2
* Town/City
* Postcode
Telephone
e.g. 0208 123 4567
* Gender
Male
Female
* Date of birth
e.g. 21-Sep-1961
* Age on race day.
* I am UKA Affiliated
Corporate team name (if any)
If you are running for a company.
Would you like to run to raise money for The Shakespeare Hospice
Yes
No
If Yes, I give you permission to forward my contact details to The Shakespeare Hospice for them to make contact with me via email.
* Would you like to make a donation to the Shakespeare Hospice?...?
Every little helps
* Do you have any medical conditions
* Emergency contact name
Contact name in case of emergency e.g. 'Bard Norris'
* Emergency Telephone
Contact telephone number in case of emergency e.g. 0208 123 4567

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