Race Entry Form

Competitor Name*
E-mail*
Phone number:*
Address:*
Emergency Contact Details:*
Race Category:*
Member?
Payments accepted by BACS to:
Ashridge Canicross
Account No: 11919529
Sort Code: 23-05-80

VIRTUAL Race Entry Fee: £6
BACS Payment Reference (if BACS payment sent):
Payment Date (if BACS payment sent):
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Terms & Conditions (please read carefully)*