PLEASE RETURN FORM TO:- To Transplant & Beyond, 91 Parkland Grove, Ashford, Middlesex, TW15 2JF

Personal Details - Please Use Block Capitals

First Name:- ... ... ... ... ... ... ... ... ...
Surname:- ... ... ... ... ... ... ... ... ... ... BTA Number (if any) ... ... ... ... ... ... ... ...
Date of Birth:- ... ... /... .../ ... ... ... ... Sex:- Male:- ... ... Female:- ... ...
Address:- ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
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Post Code:-... ... ... ... ... ... ... ... ... Nationality:- ... ... ... ... ... ... ...
Tel Home:- ... ... ... ... ... ... ... ... ... ... ...Mobile:- ... ... ... ... ... ... ... ... ... ...
(The London Triathlon Will Text You Your Race Results)
Email:- ... ... ... ... ... ... ... ... ... ... ... ... ... ... ..
Occupation:- ... ... ... ... ... ... ... ... ... ... ...
Employer:- ... ... ... ... ... ... ... ... ... ... ... ...

IS THIS YOUR FIRST TRIATHLON?  YES ( . )    NO ( . )
T-SHIRT SIZE Small ( . ) Medium ( . ) Large ( . ) X-Large ( . )

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Individual Super Sprint  ( . )     Individual Sprint ( . )       Individual Olympic ( . )     

PLEASE NOTE: All Olympic competitors will race with their own age / sex unless you specifically
wish to race in mixed sex and age group, if so tick here ( . )

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Sprint Team Relay ( . )    Olympic Team Relay  ( . )      

Team Name:- ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
(Each team member to complete a separate form. Send all three forms together)

Team Captain:- ... ... ... ... ... ... ... ..                 

Corporate Tri Challenge  ( . ) (Please tick if all Team members work for the same company)

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I enclose a Registration Fee of £75.00 for individual event or £150.00 for a Team Relay Event
Cheque(s) made payable to “To Transplant and Beyond”
(91 Parkland Grove, Ashford, Middlesex, TW15 2JF)

I declare that I accept the conditions of entry as stated by To Transplant and Beyond
To raise a minimum of £500.00 (Individual Entry) or £1000 (Team Relay)
Any athlete needing special requirements (relating to a disability or medical condition) must contact The London Triathlon pre race.

SIGNATURE:___________________________________        DATE:      /         / 2008