COAST ROAD RELAY 2006 - ENTRY FORM



For the Teams of Six event enter each name once only, for the lap that runner is going to run.

For the Teams of Three event enter each name twice - must be consecutive laps.

To assist with grading of the teams, we require for each runner recent best performance over 3 or 5 km, (or accurate estimate), and a contact name and phone number of a person who would be able to answer any queries about the appropriate grading for the team - team selector or manager.

Entries close with the race secretary Margaret Knox, 83 Glenross St, Dunedin. Phone 4776288, email: raybmarg@xtra.co.nz on Monday 11 September at 6pm accompanied by the entry fee of $6 per team member. Cheques are payable to Leith Harrier Club. Late entries will be accepted up to 30 minutes prior to race start.

 

Club / Team Name      
Grade (Circle One)

Teams of Six

Women, Masters Women, Mixed Teams of Three Women, Men, Mixed
Lap
Name

Distance 3/5km

 Estimated Time
1      
2      
3      
4      
5      
6      
Contact Name   Phone No.