Tunnels & Trails Race Entry FormYour DetailsFirst Name *Last Name *Age on 12th June 2024 *If under 18 please also fill out a Parental Consent form and bring this with you on the day.Gender *FemaleMaleClub Name (if any)0 / 180Email Address *Phone Number *AddressStreet Address *Town/City *County *Post Code *Emergency Contact DetailsEmergency Contact Name *Phone *AgreementIn 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 recognise that the event is being held on a public bridleway and that I should comply at all times with the Countryside Code. I accept the hazards involved in trail 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 10k race?YesNoWhere did you hear about this race?I can't rememberFacebookTwitterGoogle searchWirksworth RC siteEmail from Wirksworth RCJog DerbyshireOther website (please specify)FlyerVia my running clubWord of mouthOther (please specify)Please let us know where you heard about this race.Other0 / 180PaymentCredit / Debit Card *Submit EntryPlease do not fill in this field.
