| Name:____________________________________________________________________ |
Address:__________________________________________________________________ |
_________________________________________________________________________ |
_________________________________________________________________________ |
Postcode:_________________________________________________________________ |
Contact Telephone Number(s):_______________________________________________ |
Entry Fee Enclosed: £_________________ Please make cheques payable to PHSA |
It is a requirement that all participants carry third party insurance for not less than £5m. It is also strongly recommended that all participants have personal accident insurance.
I agree that the above will abide by the rules as set out in the schedule.
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Signed:____________________________ |