Canicross Anglesey Newborough 2022 Race weekend
Entry form
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Runner Name *
Address *
Email *
Telephone number *
Gender *
Category (based on age on the day) *
Races entered (Sat 5km and Sun 10Km combined for prize giving). *
Required
Estimated 5Km time *
Emergency contact details (name and phone number) *
I agree to follow Canicross Anglesey terms and conditions regarding the race entry and follow Canicross Anglesey race rules during the races. *
Payment
Payment can be made via bank transfer or Cheque.

For 1 race the total cost is £17
For 2 races the total cost is £30
For 3 races the total cost is £35
Short course is £10 per day.

Bank details are:
Lloyds Bank
Account name: Canicross Anglesey
Account Number: 46466960
Sort Code: 30-90-43
Please use the runners name as the reference.

Cheques
Please make cheques payable to 'Canicross Anglesey'
Post to
Canicross Anglesey
Bodgwilym
Lon Groes
Anglesey
LL60 6DF

Payment made by *
Signed (please type name) / Parents Signature for under 18 year olds *
Submit
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