Mike Briggs Wirksworth Incline Race Entry Form

First Name *

Last Name *

Your Details

Age on 13th April 2024 *Please note: children aged 15, 16, 17 and 18 on 31 December 2025 are very welcome to run the Main Incline Race. However to do so, please download, complete and sign a consent form and bring on the day

Gender *FemaleMale

Club Name (if any)0 / 180

FRA Membership NumberIf you are an FRA member

Email Address *

Phone Number *

Address

Street Address *

Town/City *

County *

Post Code *

Emergency Contact Details

Emergency Contact Name *

Phone *

Agreement

In entering this event, I agree that my Personal Information is published as part of the results of the Event for the event alone. Results will include name, any club affiliation, race time and age category. I consent to my name and all other data entered here being collected when I submit this form and stored for the purposes of managing the race. I understand that this race is held in accordance, and that I have familiarised myself, with both the Rules and Safety Requirements of the FRA. I confirm that I am aware of the Organiser’s information and requirements in connection with this race. I confirm that I have navigational skills appropriate for this race and will carry throughout the race any equipment specified either by the FRA Safety Requirements or by the organiser. I accept the hazards involved in fell running and acknowledge that I am entering and running this race at my own risk. Otherthan the Organiser’s liability for causing death or personal injury by negligence, I confirm that I understand that the Organiser accepts no liability to me for any loss or damage of any nature to me or my property arising out of my participation in this race.

Races Mailing ListPlease keep me informed of other races organised by Wirksworth Running Club (WRC). N.B. WRC will only use your contact details for the purpose of keeping you informed of races that it organises. WRC will not share your details with any Third Party.

Is this your first ever fell race?YesNo

Where did you hear about this race?Please let us know where you heard about this race.

Other0 / 180

Payment

£6.00

Credit / Debit Card *

All race fees are non-refundable. If you are unable to run on the day though please drop us a line at incline@wirksworthrunningclub.org.uk and we will try and re-sell your place if we have reached the maximum limit for competitors. If we are successful we will donate 100% of the proceeds to the charities that benefit from our Tunnels and Trails charity race.