western isles challenge
team entry form back to 99 admin index

 

 

 

Please enter the details requested - you can do this offline and then reconnect to your service provider to submit the form.  If you prefer you can print off a form and mail it, or download one to your own computer.

Please note the following:

1 The "Team Contact" is the person to whom all information about the event will be sent, but does not have to be an active competitor
2 In the "Experience" section for runners, we will be looking for evidence of competition in mountain marathons and/or other events requiring navigation and outdoors as well as running skills
3 Teams with an average age of 40 years qualify as veterans, for which there is a separate prize category
4 The BCU 4-Star Certificate was formerly the Sea Proficiency Certificate, which will also be acceptable, as will non-UK or Forces equivalents.  If the Certificate has already been obtained, please send a copy to Gordon Brown at the address here
5 Private Teams include Forces and University teams.  Corporate Teams are defined as teams from PLCs or their subsidiaries, or Limited Companies with 50 or more employees
6 If you are paying your entry fee by credit card and do not wish to send your details via the form, then please fax them separately to 44 (0)1859 550277.  If you are sending a cheque, this must be received within one week of submitting the form if you are in the EU, or two weeks if you are outside the EU
Team Details
Team Name

Is the Team from a  Club? Yes    No
If so, name of Club

Has the Team competed in previous Challenges? Yes    No
If Yes, please give year(s) and positions

1994 Position 

1995 Position 

1996 Position 

1998 Position 

Area of the country where you are mainly based

Team Contact Details
Name
Address (Street Address)
(Town)
(County/State)
Postcode
Country (if outside the UK)
E-mail Address
Daytime Telephone
Home Telephone
Fax
Active Team Members
1

Name

Age at 30th April 1999

  Male  Female 

If a previous Challenge competitor, please give year(s)

1994 1995 1996 1998

Main Skill

Experience

2

Name

Age at 30th April 1999

  Male  Female 

If a previous Challenge competitor, please give year(s)

1994 1995 1996 1998

Main Skill

Experience

3

Name

Age at 30th April 1999

  Male  Female 

If a previous Challenge competitor, please give year(s)

1994 1995 1996 1998

Main Skill

Experience

4

Name

Age at 30th April 1999

  Male  Female 

If a previous Challenge competitor, please give year(s)

1994 1995 1996 1998

Main Skill

Experience

Other Details

Does the team canoeist have a BCU 4 Star Certificate? Yes   No 
Are you applying for a Reserved Place? Invited   All-Female   Veterans   Local
Estimated number in your backup team
We expect to use the event to raise money for Charity Yes No
If yes, which Charity?
Fees
Private Team (£300 + VAT = £352.50)
Corporate Team (£500 + VAT = £587.50)
Our entry fee will be sent by cheque
Please charge our fee to this credit card
Card Details Card Number
Expiry
Name on Card

 

Declaration by Team Contact (By submitting this form you are agreeing to this Declaration)
On behalf of the above team, I have read, understood and accept the outline rules for the Western Isles Challenge 1999