Canoe – Kayak Online Entry Form

Canoe – Kayak Online Entry Form

**** Before you complete the Canoe – Kayak Entry Form please make sure you have read and understood the Race Rules ****

Rother Raft Race Canoe – Kayak Entry Rules

ROTHER RAFT RACE CANOE & KAYAK ENTRY FORM

Please complete the application form below.

Your Name (required)

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

Subject

Canoe/Kayak Details -

	Name of Canoe/Kayak
	Name of Firm, Organisation etc
	Please enter the Category you wish to be entered. Categories can be found on the entry rules page.

Canoist/Kayaker Details -

	Canoist/Kayaker 1

		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
	Team Member's Name
	Contact Number (in case of an emergency)

	Team Member 3	Male Female
	Team Member's Name
	Contact Number (in case of an emergency)

	Team Member 4	Male Female
	Team Member's Name
	Contact Number (in case of an emergency)

T-Shirts -

	(Size) -	(Number Required)
	Medium
	Large
	Extra Large

Entry Fee -

	Entry for 2011 Rother Raft Race is £15.00 per rafter. Please Note: There is a minimum requirement for raffle ticket sales (Adults £30.00 and Youths £20.00 per individual) Please send cheques payable to 'Rother Raft Race' to:

	FAO Anthony Weller
	ROTHER RAFT RACE
	Longfield
	Midhurst Road
	Fernhurst
	GU27 3HA
	(Cheques to be received by Thursday 25th August 2011)

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

Rother Raft Race

Sunday 28th August 2011

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