Inflatable Obstacle Registration Form


1. Full name:


2. Address:


3. Telephone no.


4. Email:


5. Running as an individual or in a team?


6. Your team or organisation name:


7. Does your team have a name (e.g Fallen Angels or Smithy's Solicitors):


8. What distance to you plan to enter:


9. Do you have any under 16's participating in the run?


10. Would you like a Wellbeing in Action running top on the day? (This costs £10 but is free for fundraisers raising £25 or more for the charity)


11. How will you be fundraising and what support would you like?


12. Do you have any disabilities, barriers to participating or practical support needs that will help you to take part and enjoy the day fully? Please let us know so we can see if we can help.


13. Are you happy for us to use your contact details to send you updates and information about the event and also for us to feature any photographs, video or media that might contain images of you as part of the publicity prior or after the event? We do not sell or pass your details to any third parties.