Thank you for visiting our site. We would appreciate your entry in this year's race.

Remember our closing date is Sunday 04th April 2010 p.m. Registration Fee $5.00

 
*Firstname:
*Surname:
*Date of Birth(MM/DD/YR): *Sex: Male Female
*E-Mail Address:
*You are a : runner walker wheel chair athlete
*You are a : local athlete visitor
Club/School:
If you are a local athlete please fill in
Street: District :
Parish: Postal Code:
Home Telephone:
Work Telephone:
Mobile Phone:
If you are a visitor please fill in
Hotel/Apartment/Guest House :
Address :
 City:
State:
 Postal Code:
Country:
  
  Telephone:
* All these fields must be submitted
    
 
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