EXTREME RUNNING

Entry Form

First Name :
Last Name :
Tel Mobile :
Tel Home :
Tel Mobile/ Work :
Email :
Street Address:
Town/City:
County:
Post or Zip Code :
Country :
Nationality :
Occupation :
Date of Birth :	*minimum age for male and female entries is 20
Sex:
T-Shirt Size:
Please put a few notes about your previous experience:
Event Name :
UKA affiliated club :	(if applicable)
I am an amateur runner :
How did you hear about this event :

TERMS AND CONDITIONS
I understand that participating in this event is potentially hazardous and that I will not do so unless I am, as far as I can ascertain, medically fit and fully trained.

As a consequence, I recognise that I am entering this event at my own risk and assume complete responsibility for any injury or accident, whether on the way to or from the event, during each stage or at any premises or place used for the event.

I accept that Extreme Running Limited, its officers, employees and assistants shall not be liable for any injury, loss or damage that I, or any dependent, shall suffer as a result of my competing in the event.

I confirm that I have read and understood the Regulations, Terms and Conditions of this event and that I accept these in full and without reservation. I further declare that I am intending to participate in the event with full knowledge and complete understanding of the personal risks that this may entail. I certify that the information I have given on this form is correct.

On submitting this entry form the deposit or full payment for the event I am participating in will be made.

Extreme Running Limited nor any of its associated companies will not sell or otherwise transfer any information supplied to it by entrants for marketing. We may, however, retain your details to contact you about other events.