1. Choose one of these Options Below

Enter Race Distance 10 Km Night Race in January 10 Km Night Race in February 10 Km Night Race in March 50Km Jackie Mekler 25Km Mini Mekler 10Km Memorial 10Km Spirit of Flight

2.  Fill in the following Personal Information

Name
Surname
Id No
Foreigner Athlete	Yes   No    If Yes Type in your Id No
Address
Tel
Cell
Gender	Select Male Female   Date of Birth
Fax
Email
Temp Lic	Select Yes No
2005 Licence
Province	Select BOL BDR CNW EP FS GW LP MPL NWC NWN SWD AVT WP AGN CGA WP KZN NOT LISTED
Entry Fee
Temp L Fee
Total
	Confirm

3.    When this form is filled in make sure to deposit the money in the following

       bank account: WSK  PTA, ABSA  Branch 626245, Acc Type: Cheque,  Acc No: 1054733590

     and fax the deposit slip to

       0866852577

       Runner must use their own  ID No as Reference on the Deposit Slip

4.    Enter any comments in the space provided

:Enter your Compliments/Complaints or Suggestions max 100 characters

I hereby understand that the club will not be held responsible if I the

      athlete are not fit to complete in this race i have entered for and

     No Refunds of Entry Fees.