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

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.

Age Confirmation

I confirm that I am aged 18 or over. I understand that registrations from anyone under the age of 18 cannot be accepted.

Digital Signature

Please Type Your Full Name