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MANSFIELD SHORT COURSE TRIATHLON ENTRY FORM
400 Metre Pool Swim : 12 Mile Cycle : 3 Mile Run

Sunday 15th June 2003. Warsop Leisure Centre, Mansfield, Nottinghamshire

"Part of the East Midlands Triathlon Series 2003"
Name Surname
Address
Postcode Club
Daytime Tel. Age On 31/12/2003
Sex. Male / Female BTA Race Licence No.
Email Address

If you wish to view Race Information & Race Results on our race website then please DO NOT send 2 x SAE's, but please complete the question below.
I wish to view Race Information & Results on website Yes / No
Have You Completed A Triathlon Before?�� Yes / No
Have You Taken Part In This Event Before?�� Yes / No
Do You Have Any Medical Conditions The Organisers Should Be Aware Of? Yes / No
How Did You Hear About This Event? T-Shirt Size?�� Med / Large / Ex - Large
Expected 400 Metre Swim Time? Minutes / Seconds
Expected Total Finish Time? Hours / Minutes
Please Complete The Following If You Wish To Enter A Relay Team
Team Captain Team Name
If you are not a British Triathlon Association (BTA) member, you are required to purchase a day membership to take part in a BTA sanctioned event. �A day membership provides you with civil liability and personal accidents insurance cover during the event. �The cost of day membership for this event is �3.00.
If You Are Not A Member Of The BTA Please Tick The Following Box
� I wish to apply for a BTA day memberships and agree to details of my name, address and date of birth being forwarded to the BTA for the purpose of registering my day membership and insurance cover. �I further agree to abide by the conditions of membership and rules of competition of the BTA details of which are published on www.britishtriathlon.org or you can contact the BTA on 01509 228321.

I (On behalf of the above team) declare that we will abide by the rules of the British Triathlon Association and accept that One Step Beyond Promotions and their friends and associates are not liable for any loss, damage claim or expense which may arise in consequence of my participation in the event. All athletes must obey the Highway Code. Tick box if you do not wish to receive details on future events & promotions relating to this event.

Signed:������������ ����������������������������������������������������������� Date:

Entry Fees: BTA Members �20� Non BTA Members �23 including BTA Race Day Licence
BTA Teams �30 (All team members must be BTA Members). Non BTA Teams �39
Please make cheques payable to: One Step Beyond
*Please also include 2 x 8 x 6 stamped addressed envelopes.
Send completed entry forms, cheque and *stamped addressed envelopes to:
Mansfield Short Course. One Step Beyond Promotions
33 Perivale Close, Nuthall, Nottingham, NG16 1QG
Tel. 0115 919 00 96� Email [email protected]� Website� onestepbeyond.org.uk
Closing Date For Entries June 2nd� 2003

ENTRIES ARE LIMITED TO 400

*Complete the section above if you wish to view Race Information & Results@ www.onestepbeyond.org.uk
CASHING OF YOUR CHEQUE CONFIRMS YOUR PLACE IN THE RACE

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