Entry Form Please copy and paste this form to print it out
MICHAEL DUCKSBURY MEMORIAL SPONSORED TRACTOR ROAD RUN
SUNDAY JULY 4th 2010
9:30am to leave at 10am
College Farm, Newcastle Street, Tuxford, Newark, Notts. NG22 0LN.
ENTRY FORM
NAME ______________________________________________________________
ADDRESS ________________________________________________________________
____________________________________________________________________
TEL _____________________________ EMAIL _______________________________
MAKE of TRACTOR _______________________________________________________
MODEL __________________________ YEAR ________________________________
Entry is by sponsorship or a minimum donation of £10. All funds raised will go to Weston Park Cancer Hospital, Sheffield.
Refreshments at the lunch break are included.
My sponsors are listed below:
NAME | ADDRESS | AMOUNT | PAID |
Please continue overleaf.
Completed forms to be returned to Sam Ducksbury. College Farm, Tuxford, Newark, Notts. NG22 0LN. by 21st June 2010
All enquiries: Tel Paul on: 01777 838122 or E-mail Sam at: dumbles93@tiscali.co.uk
