Leeds Children's Charity | Holiday Centre for Children

For information about the charity contact

Brightening Children's Lives Summer Ball

Jane Tomlinson Leeds 10K 2012
8th July 2012

The 2011 event was a great success as approximately 30 people ran on behalf of the charity and raised a combined total of around £10k on behalf

of the charity. Our thanks go out to all of those who went through sweat, blood and tears to make it round the course!

Help us to continue our vital work with underprivileged children by donating today!

VIA PAYPAL

VIA JUST GIVING

Jane Tomlinson Leeds 10K 2012 - Athletics Club Membership Registration - 8th July 2012

Let’s Get Running...

Please fill in your details and begin your journey towards brightening children’s lives.

You will receive a confirmation email following registration.

Registration Cost: £24

Please Note:
All runners must be over 15 years of age on the day of the race. Athletes with physical special needs/disabilities other than wheelchair competitors please contact info@leedschildrenscharity.org.uk to complete registration.

Title*
First Name*
Last Name*
Athletics Club Membership No*
Address Line 1*
Address Line 2
Town*
County*
Post Code*
Home Telephone*
Mobile Phone

Date of Birth

Min. Age 15 on Race Day

Email*

Confirm Email*

Gender*

Male

Female

Gift Aid Agreement

Predicted Completion Time (Hrs & Mins)*

Best 10K Time (in last 12 months)

Where did you hear about the event?

Other

	Note: Tick box if you DO NOT WANT to receive email updates and race details on this and future events. The details will be stored on computer for future mailings.
	I have read, accept and agree to all conditions of entry available here I acknowledge that the event sponsors, race directors, or any person involved in the organization of the event shall not be liable for any injury, accidents, loss or damage suffered by me in, or by reason of the event, however such may be caused. I am HEALTHY and have NO KNOWN medical conditions or any other reason why I should not participate in the event. Cashing your cheque confirms your entry into the race.*
	In the event of cancellation for reasons beyond our control the entry fee will be donated to charity. If you would prefer to receive a refund please tick the box
	*Required Fields

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