BOX HILL ATHLETIC CLUB
PRESENTATION NIGHT
TRACKSUIT TOP
5 KM HANDICAP
Presentation Night
Saturday 28 April 2001, 7:00 pm
Hawthorn Football Club, Linda Crescent, Hawthorn

No of seniors @ $40 per head :

______________________

No of juniors (Under 18) @ $30 per head :

______________________

Total Cost :

$_____________________


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Club Tracksuit Tops
Samples availble to check sizes - refer to Adam Pepper for details
$85 each - prepayment essential
Please circle the size required:
SMALL MEDIUM LARGE EXTRA LARGE


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5 km Handicap
Saturday 28 April 2001, 1:00 pm
Leaving Box Hill Athletic Club at 12:30 pm


I will / will not be competing in the 5 km Handicap on 28 April


My best recent times for the following distances are:
5000 m  _________________
3000 m  _________________
1500 m  _________________


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Name:________________________________

Total Payment Enclosed: $ ______________

Credit Card Payment Details :
Please circle card type:
VISA MASTERCARD BANKCARD
Card Number
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Expiry Date: _________ / __________

Name on card:________________________
Signature:_____________________________

Please return to: Box Hill Athletic Club, PO BOX 247, Box Hill VIC 3128