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LONG DISTANCE WALKERS ASSOCIATION
Standard Entry Form
www.ldwa.org.uk

After completing the form, on screen, print it by clicking the 'Print Form' button below, sign it and then send the completed form direct to the EVENT ORGANISER
Note this form can only be used for those events marked 'SEF'

Name of Event
Route/Distance
Date of Event //20 (dd/mm/yy)
Name as to appear on certificate
Please check as appropriate Male Female Walker Runner Vegetarian
Address
Postcode
Email Address
Tel. No. [Inc. STD Code]
LDWA Number
LDWA Group Name
Mobile Phone No. (If carried on walk)
Car Reg. (If left during walk)
Tel. No. in case of emergency
Any medical condition/information which may be relevant in case of accident (Will be in strict confidence)
Cheque Enclose Value £ Please see Strider for amount and account name
Do not make cheque payable to event organiser

I enclose a SAE for confirmation of my entry, route description and details of event rules. This is obligatory. I agree to abide by the rules of the event and to observe the Country Code at all times. I have sufficient knowledge, experience, equipment and navigational skills to take part in a long distance walk in all conditions. I confirm that I am in good health and have no medical condition that may cause undue concern or inconvenience to others. I confirm that I participate at my own risk and that no liability is accepted by the organisers for injury, damage or loss sustained by me before, during or after the event. I will be over 18 years old on the day of the event. I understand that particular rules may apply to entrants taking part in this event and I undertake to make myself aware of these rules before I start.

Signature: _ _ _ _ _ __ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date:

Notes
  1. This form should only be used for events marked 'SEF' in the Future Events section of Strider.
  2. This form, or a photocopy, should be sent to the organiser of the event at the address given in Strider.
  3. A separate form should be used for each entrant.
  4. This form should not be used for under 18's who should send for an entry form to the event organiser enclosing a SAE as particular rules or restrictions may apply.
  5. Details will temporarily be held on a computer for the sole purpose of administering the event. The LDWA is registered under The Data Protection Act.

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