Online Entry Form |

Online Entry Form

Before you complete the Entry Form please make sure you have read and understood the Race Rules.

Please click here to view the Entry Rules and Categories.

ROTHER RAFT RACE ENTRY FORM

Please complete the application form below.

Your Name (required)

Your Email (required) Copy of application will be sent to this address.

Subject

	Name of Raft

	Name of Firm, Organisation etc

	Please enter the Category you wish to be entered.
	Categories can be found on the entry rules page.

Team Leader's Details -

	Name of Team Leader

		Male Female

	Address 1
	Address 2
	Town/City
	County
	Postcode
	Phone (Home)
	Mobile
	Email Address
	(if different from that above)

Team Members Details -

	Team Member 2

		Male Female

	Contact Number (in case of emergency)


	Team Member 3

		Male Female

	Contact Number (in case of emergency)


	Team Member 4
		Male Female

	Contact Number (in case of emergency)

T-Shirts -

	(Size) -	(Number Required)

	Medium

	Large

	Extra Large

Entry Fee -

	Entry for 2009 Rother Raft Race is £7.00 per rafter. Please send cheques payable to 'Rother Raft Race' to:

	FAO Anthony Weller
	Unit 6 Index House
	Midhurst Road
	Liphook
	Hampshire
	GU30 7TN
	(Cheques to be received by Saturday 21st August 2010)

Please add any additional information below:

We all accept to abide by the Rules and Regulations of the Rother Raft Race Organisers and the Race Marshall's on the day. We accept that the organisers are not responsible for any death or injury which may ensue as a result of participation in this event