The Misbourne 5k and 10k 2024

My Details

First Name *

Last Name *

Date Of Birth *

Gender *

Male Female *

Club or Team

Club or Team: *

Registration No *

My Contact Details

Email *

Phone Number *

My Address

Address Line One *

Address Line Two

Town/City *

County

Postcode *

Country *

Emergency Contact Details

In case of an emergency please provide the name and contact number of someone who is NOT running.

Emergency Contact Name *

Emergency Contact Number *

Additional Information

If you are a Misbourne student please tell us which year group you are in.

Please tick this box if you are a Misbourne staff member.

Predicted Finish Time

Please tell us your expected finish time. *

Declaration

I HEREBY DECLARE THAT ON 22 JUNE 2024 I will be 16 years old or over (** runners aged 16-17 must provide details of the consenting parent/guardian below) and an amateur as defined by UK Athletics Rules. I will only participate in the race if medically fit to do so. I hereby accept that to the full extent permitted in law, race organisers and sponsors shall not be liable for any accidents, injury, loss, or damage whatsoever and howsoever arising as a result of my participation in the race. I also accept that my entry is subject to the organisers discretion and that no refund of the entry fee will be made as a result of cancellation of the event. No wheeled vehicles (prams, buggies etc), dogs, following cycles (other than official race personnel) are allowed on the course. I agree not to wear headphones whilst participating in the race. I consent to the release of my personal medical details by the medical team to race organisers in the event of a medical emergency. I allow organisers to keep my contact details stored so as to allow them to contact me regarding this and future Misbourne 10K runs. This information will not be passed on to third parties.

I have read and understand the Terms & Conditions *

If the entrant is under 18 on race day the parent/guardian details must be provided. By providing these details you are confirming that you have parental permission

Parent/Guardian's Name

Parent/Guardian's Tel. No:

Data Protection

The personal information gathered by Sport Systems when you place your order will be used for administering the event such as contacting you by phone or email to check details or correct a typo in an address. The users of this could be Sport Systems, the race organisers, or any appointed third party, such as an official photographer, or a different race timer. Certain details such as your name, event category and running club, but not contact data, may appear on various results websites, results emails, text messages and could even appear in newspapers.

I have read and understand the Terms & Conditions *

We would also like to keep you informed about future editions of this event and also others with which Sport Systems are involved but you need give us permission (opt in) to do this to. Please answer the following two questions one on behalf of this event and the other on behalf of Sport Systems. (If you are answering on behalf of another person please check they are willing for you to do so).

Please keep me informed of future editions of this event. *

Please keep me informed of other events with which Sport Systems are involved. *

Donations

The Misbourne School invites you to make a voluntary donation towards sports kit for the school. Below are some examples of what the money raised could buy: £5 – a table tennis bat £10 – a sports ball – netball, volleyball, football… £20 – tennis racket, rugby ball £50 -cricket set, set of numbered team bibs.

Choose an amount:

�5

�10

�20

Other (�)

No Donation

Gift Aid Declaration:

* I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference.

The Misbourne 10k