BQA Race Affiliation Form 2020
Email address *
RACE TITLE *
CLUB or ORGANISATION
CONTACT NAME *
ADDRESS *
POSTCODE *
TELEPHONE NUMBER(S) *
ABOUT YOUR RACE
Proposed Date
MM
/
DD
/
YYYY
LOCATION
WEBSITE ADDRESS
EMAIL ADDRESS FOR USE BY COMPETITORS
DISCIPLINES
Please select all that apply
RACE DESCRIPTION
Please give a description the BQA can use to help publicise your race. Please include distances of disciplines and if cycle or run are off-road.
DO YOU WANT TO USE BQA INSURANCE? *
WOULD YOU LIKE YOUR RACE TO BE CONSIDERED FOR:
Please select any that apply
PAYMENT DETAILS
Please send £20 affiliation fee.
Please send cheques to: BQA Secretary, Jean Ashley, 2 Stockton Cottages, Oldcastle Heath,
Malpas, Cheshire, SY14 7AE.

OR

Pay by bank transfer to BQA at sort code 40-18-03, account no. 21122584.
Please ensure you include identifying details as a Reference
DO YOU WANT TO PAY BY *
DO YOU WANT AN EMAIL WITH BANK ACCOUNT DETAILS? *
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