C25k Registration - Widnes Running Club

C25K Registration Form

Title *

Name *

First

Last

Date of Birth *

Enter your DOB in the format dd/mm/yyyy - for example 01/10/2000 for 1st October 2000

Mobile Phone Number *

Email *

Email

Confirm Email

Emergency Contact Name *

First

Last

Emergency Contact Number *

Club Code of Conduct *

Disclaimer *

I confirm that I understand that my participation in training sessions organised by the qualified leaders of Widnes Running Club at organised club sessions is entirely at my own risk and I should consult my own doctor if suffering from any condition that might make running injurious to my health.

Digital Signature *

Please Type Your Full Name

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