PEMBROKE – SWIEQI ROAD RACES

23rd Edition

Under MAAA rules

DATE: FRIDAY 31ST MARCH 2017

A SPORTS & FUN FESTIVAL from 9.30 am to 2.30 pm

VENUE: PEMBROKE ATHLETA SPORTS CLUB – William Harding Street, Pembroke

RACE TIMES:

8.35 am / VEE GEE BEE Road Race / 5 km / Entrants 16 yrs or older on 31st March ‘17
8.40 am / A to Z Electronics Road Race / 10 km / Entrants 16 yrs or older on 31st March ‘17
8.45 am / KIABI Walkathon / 7 km / Entrants 18 yrs or older on 31st March ‘17
10.00 am / ATTRANS and FONTANA Road Race / 3 km / Cadets born ’04/’05 & Youths born ’02/‘03
10.30 am / NESQUIK Fun Run / 1.2 km / All ages

ENTRY FEES: 10km - €13; 7km - €10; 5km, 3km - €8; 1.2km - €5

WATER: Water stations will be available at the 3km, 5km, 6.5km marks and at the finish line

CLOSING DATE: SATURDAY 25TH MARCH 2017

LATE ENTRY FEES: 10km - €20; 5km, 7km - €12; 3km - €10

Supported by:

SURNAME: / NAME:
ADDRESS:
POSTCODE: / NATIONALITY:
TEL/MOB No. / TICK SEX: / FEMALE / MALE
E-MAIL: / DATE OF BIRTH:
NAME OF CLUB /SCHOOL:

The organizers pledge that personal information divulged in this application will be used solely for race administration purposes, in accordance with the Data Protection legislation of the Republic of Malta.

Please Tick this box if you do not wish to receive commercial/promotional material from our sponsors

______

KINDLY TICK IN THE BOX AGAINST YOUR ENTRY

EVENTS - FRIDAY 31st March 2017 / TIME / FEE / / Late entry fee
1. 5 km Race (Persons born 2001 or earlier) / 08.35 am / €8 / €12
2. 10 km Race (Persons born 1999 or earlier) / 08.40 am / €13 / €20
3. 7 km WALKATHON ( Persons born 2001 or earlier) / 08.45 am / €10 / €12
4. 3 km Race (Cadets born 2004, 2005 Youths born 2002, 2003) / 10.00 am / €8 / €10
5. 1.2 km FUN RUN (For all ages) / 10.30 am / €5 / no extra fee

Ø  In accordance with MAAA regulations, children born 2006 or LATER can ONLY take part in the FUN RUN.

To qualify for the special locality prize, Pembroke & Swieqi residents running in Race 2 or in Race 3 must be in possession of a Maltese I.D. Card, which may be required to claim the locality prize.

DECLARATION: On submission of this entry I, the undersigned, declare that I am physically fit to participate in the event indicated above; undertake to abide by the rules governing the event; will not hold the organizers or sponsors responsible for any injury, loss or accident, sustained as a consequence of my participation.

______

SIGNATURE PARENT’S SIGNATURE (IF UNDER 16 YRS OF AGE)

I enclose herewith cash / cheque / money order no.: ______being the amount due in respect of my/our entry fee/s.

A Money Order/Cheque for the appropriate fee/s is to be made payable to:

PEMBROKE ATHLETA ATHLETICS & TRIATHLON and posted to:

81, Triq Birkirkara, San Gwann SGN 4193 or 80, Triq Sghajtar, Naxxar NXR 3312

E-mail: Mobile: 99255595 / 99325764(This form may be photocopied)