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Signature Date Send completed form to Derwent AC Chestnut House The Green Little Broughton Cockermouth CA13 0YG to arrive no later than 16 May 2017 Please do not send race fee - all our races are pre-entry pay on the day Entries on the day at Derwent AC Clubhouse Kirkgate subject to race limit. 00 Entry on the day 1 Extra Name Date Of Birth Club Age on race day UKA Number Junior Male Male MV40-50 MV50-60 MV60-70 MV70-80 MV80 Female FV35-45 FV45-55 FV55-65 FV65-75 FV75 Address Telephone Email...
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