adidas WOMEN'S 5K CHALLENGE 2008

Enter Birmingham adidas Women's 5K Challenge (Birmingham)

Use the form below to enter your details. Once that is complete you will be forwarded to a WorldPay page in order to enter your payment details. If you do not identify a charity your donation will go to the London Marathon Charitable Trust which supports sports and recreation projects in London, Liverpool and Birmingham.

*First name
*Last name
*Email
*Email conf
*Telephone
Gender	Female :
*Date of birth
*House street
District
*Town city
County
*Postcode
*Country
*Heard about
	£5 of your £15 entry fee will be donated to charity. Please choose ONE charity, or add your own: Your details will be passed onto the charity you have selected. You are not committed to raise sponsorship money for this charity. Please EITHER select one from this list:
	Tick here if you are happy for the charity to send you a fundraising pack with details of how you can help raise additional funds.

	OR select one from this list. However, for the selections below you will need to contact the charity if you wish to raise funds:

	OR add your own charity choice, including its full name, address and postcode.
Charity name
Charity address1
Charity address2
Charity town
Charity county
Charity postcode
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