RUSHLAKE GREEN ENTRY FORM
APRIL 12TH 10.00 START
Name
*
First Name
Last Name
Email
*
example@example.com
Route
*
Blue (Intermediate)
Red (Clubman)
Yellow (Beginner/OAP/)
Please tick which box is appropriate
*
Adult member £15
U16 member £5
Adult non-member £25
U16 non-member £10
Emergency Contact Number
Name
Phone Number
Submit
Should be Empty: