WELSH  MASTERS  INDOOR  CHAMPIONSHIPS/OPEN 2012

(Under UKA Rules)

DATES         Sunday 8^th  January  (Part 1)    &   Sunday 19^th February  (Part 2)

National Indoor Athletic Centre, UWIC, Cyncoed, Cardiff, CF23 6XD

 

AGE GROUPS         W35+/M35+ 
As
 of  the 8^th January 2012   &  19^th February 2012

ENTRY FEE       £7.50 for 1 event.  £15.00 for 2 events.  £20.00 for 3 events.   £25.00 for 4 events

CLOSING DATES                  30^th December 2011  for the 8^th January 2012 meeting

                                                10^th February 2012  for the 19^th February 2012 meeting

ENTRIES ARE NOW CLOSED

 Please send entry froms to

Sue Hooper,    28 Mill Common, Undy, Monmouthshire, NP26 3JH

hooper_pencoed@btinternet.com 

 Entries and final timetable will be published on the website

It is the responsibility of the competitors to check the website to confirm their entry prior to the closing date.

All competitors must declare there intention to compete in each event 1 hour before the start of that event

No entries will be accepted on the day.

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ENTRY FORM   (Please fill in all sections)

Surname______________________________________Forename(s)___________________________________

Address____________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 Tel Number _________________________________E-mail_________________________________________

CLUB_____________________________________ ______________________________________________

   Masters Age group__________________________________________________________________________

Welsh Masters Membership No_______________________________________________________________

Welsh Athletics Regristration No______________________________________________________________

OPEN COMPETETORS ONLY________________________________________________________________

(Other Master/Veteran Association or Number)

 Events        Please Circle   

January 8th    200m  /  800m  /  Pole Vault  /  Triple Jump (completed)

February 19th   60m  /  400m  /  1500m  /  High Jump  /  Long Jump  /  Shot

DECLARATION I declare that I am an amateur.  I am qualified to enter the Welsh Masters Athletic Association Championships and do so at my own risk.  I understand that drug testing may take place and that I may be required to submit to a test.

I enclose payment for £____________ cheques made payable to   WELSH ATHLETICS Ltd

Signed_________________________________________