Race Entry Form for 2107 Perran Dash on Friday 16th June

1. Perran Sands Dash 2017
This multi terrain 4 mile beach run starts at Chapel rock at low tide and heads straight to the
Penhale end of Perranporth beach. Turn at the cliffs and head backto the Haven Holiday Park
steps, up onto the South West coast path , over the cliff and back down ontothe beach tothe finish
line.
A multi terrain race with a challenging climb at the end!
The 1 mile fun run alsostarts at chapel rock and heads towards flat rocks for 0.5 miles then back
0.5 miles to the finish adjacent to the Watering Hole pub.
Entries on the day are allowed and there will be an additional £1 fee payable.
The start line is at Chapel Rock on Perranporth Beach
On the route follow the direction indicators or Marshals instructions
Please keep to the footpath on the cliff section of the route
All 4 mile runners must be over the age of 15 yrs
Drinks and a goodie bag are available at the end of the fun run and the 4 milerace (not guaranteed
for late 4 mile entries)
Prizes
Male and female and team prizes in standard age categories
All entrants to both races will receive a medal on finishing.
Race Entry Form: Perran Sands Dash 4 mile race/ Kids 1 mile fun run (Please circle)
Surname__________________Address_________________________________________
First Name_________________
Date of Birth / / Postcode_________________________________
Age_____ Telephone________________________________
Male orFemale (please circle) Email____________________________________
Affiliated Yes/No (please circle)
UKA number________________________Club name__________________________
Medical conditions________________________________________ _________________________________
Race entry fees
Affiliated runners £8.00
Non-affiliated £10.00

2. Fun Run entrants (age14 and under) (£3.00)
Data Protection: The information provided by you on this form will be used solely for the purpose
of compiling race results and for health and safety reasons. The information will only be available
to race officials and willnot be passed to any other person oragency.
I understand that while the organisers will make every effort to ensure my safety, I accept any
risks involved and they will not be responsible for any injury loss or damage suffered by me while
participating in this event. I declare Iwill be medically fit, over 15 years of age on Friday 16th June
2017 and abide by UK Athletic rules for this event.
Signed________________________________________Date______________________________
Total Fee enclosed________________________________________________________________
Parent or guardian to sign if under 18 years old.
Closing date for postal entries Tuesday 13th June 2017
Please complete the entry form above and send with a cheque made payable to‘Friends of
Perranporth School’ to
J.Salmon
12 Hendrawna Meadows
Perranporth
TR6 0FH
Enquiries: 07837350462 or email jennyno2407@gmail.com
Race numbers can be collected between 5.15pm and 6.30pm