T & F Championships entry form VETERANS A.A. N. E.E. TRACK & FIELD CHAMPIONSHIPS 2012 Saturday 23rd June at MONKTON STADIUM JARROW Field events start at 11.00 am with the Javelin. Track 11.45 pm with the 100m Hurdles Entry Fees £5.00 for first event, £1.00 for each subsequent event. Cheques payable to"Veterans A.A. - NE". Send to Vicki Thompson 1 The Avenue, Birtley. DH3 1AA Entries open to : VAANEE MEMBERS ONLY NO ENTRIES ON THE DAY Closing Date for entry Monday 18th June Events - Men & Ladies PLEASE TICK EVENTS YOU WISH TO ENTER. Javelin ................ 100/110m Hurdles ................. Discus ................. 100m ................ High Jump ........... 1500m ............... Shot ................... 400m ................ Hammer ............. 200m ................. Long Jump .......... 800m ................. Heavy Weight ...... W & M65+ 3000m ................. Triple Jump ......... M35-64 5000m ................. Senior and Ladies Open 1 Mile at 2.15 pm. Entry £2, please pre-enter, but entries will be taken at the meeting. Please indicate Age Group _____ (age as at 23rd June 2012) 35 - 39 .......... 40 - 44 .......... 45 - 49 .......... 50 - 54 .......... 55 - 59 .......... 60 - 64 .......... 65 - 69 .......... 70 - 74 ........... 75 - 79 ......... 80 - 84.......... Name ................................................. Age ........... Date of Birth .............. Address ..................................................... Male/Female ............... ................................................................ ................................................................. Club ................... .................. Post Code ....................... E-mail .......................................... Tel. No. ............................... Amount Encl. £ .............................. England Athletics Registration No. ............................................... VAANEE Number .............