Run Fest Sun 26th Sept 2021

Sun, Sep 26th 2021 at 9:30 am - 12:30 pm

Fund-raising fun run - the first venture of the satellite group!


See the source image

Rotary Satellite Club of Welwyn Garden City

 

 

 
For a downloadable version of this form, please contact Ian Critchley at iancritchley@ntlworld.com

Rotary RunFest – Sign-up Form

Sunday 26th September 2021

 

 

Name

 

If under18 please state age

 

 

E-mail address

(Parent or Carer if under 18)

 

 

Phone Number

(Parent or Carer if under 18)

 

 

Distance

Entry Fee

Select Entry

2km – Individual

£3

 

2km -Family*

£10

 

5km – 9:40 start

£8

 

5km – 9:50 start

£8

 

10km – 9:30 start

£15

 

 

* 2km Family – list additional names

 

 

 

Entry Fee

 

Additional donation

 

Total

 

 

 

For administration only

Paid

 

Date

 

Payment method

 

I have read and understood the agreement and waiver

 

I am physically fit and able to safely take part in this event

 

I do /do not have a medical condition that may impact my ability to safely complete this event

 

DO / DO NOT *

 

Please delete as appropriate

If you do have a medical condition, please give details here

 

 

 

Emergency contact name

 

Emergency contact phone number

 

 

Signed

 

Date

 

 

Agreement and waiver

  • The nature of the event includes running on varied terrain and as such are liable to changing weather conditions (rain, snow, hail, sunshine, low cloud, mist, high winds).
  • Routes will use roads, paths, tracks, and trails open to public users, which include walkers, horse riders etc.  Other risks may include, but are not limited to, encounters with animals and insects. I acknowledge and agree to extend due care and courtesy to all users during the event.
  • Participation in such an event carries with it certain inherent risks and dangers that cannot be eliminated.  I assume full risk and responsibility for any injury or accident that may occur during the event, while travelling to or from the event, or while on the premises of the event.
  • I am medically able to participate in this event.  Any medical condition I may have has been declared to the event organizers.
  • Neither the event organizer nor anyone working for the race is responsible for any personal item or property that is lost, damaged or stolen during the event.
  • I grant permission for the race organizers to use any and all images or film (video/ moving content) of me captured during the race and allow these images to be used in marketing materials including but not limited to online, print and broadcast media.
  • I agree to release Rotary, its members and volunteers from any and all liability, claims, demands, negligence, actions, and causes of actions whatsoever for any loss, claim, damage, injury, illness, legal fees or action arising out of my participation in a Rotary event.

Data provided to Rotary will be stored in line with GDPR requirements.   Contact data will be used to communicate updates for this and future events.  Should you not wish for your data to be stored and used for this purpose please tick the box   ⎕