Name * First Name Last Name Email * Phone * (###) ### #### Date of birth * MM DD YYYY Emergency contact name and number How would you describe your current running level? New to running Returning to running after a break Running regularly but want to improve How often do you run per week? Never Once or twice Three or more times How long do you run for on average? Less than 10 minutes 10 to 20 minutes 20 to 30 minutes More than 30 minutes Do you have any medical conditions or injuries that may affect your running? Do you have any specific running goals or challenges that you would like to achieve?. For example, completing a 5k, 10k or half marathon, improving your speed or endurance, or joining a social running group Please read and agree to the following terms and conditions before submitting your form: I confirm that I am 18 years or older and that I have read and understood the programme details and requirements. I acknowledge that running is a physical activity that involves risks and that I am responsible for my own health and safety. I consent to the club using my personal data for the purposes of the programme and contacting me with relevant information and updates. I consent to the club taking and using photos and videos of me for promotional and educational purposes, unless I opt out by emailing willowfieldweb@yahoo.co.uk. I agree to the above terms & conditions Thank you for completing the registration form. We will be in touch soon with more details about the programme and what to expect on the first night. We look forward to seeing you at the Pavilion, Stormont Estate, at 6:30pm on Monday 2nd September 2024
