Step 1 - Please enter your details:

* required fields
* First Name:
* Last Name:
* Address Line 1:
Address Line 2:
* City/Town:
* County:
* Postcode:

* Telephone Number (inc std):
* Email Address:

* Date of Birth:
* Gender:	Male Female

* Are you a member of an affiliated club?:	Yes No
* Affiliated club (If no leave blank):
Your EA Registration Number (URN) if known:

* T Shirt Size:	S , M , L , XL

I agree to abide by the current laws and rules of competition of UK Athletics. I declare that I am fit and that I intend to run entirely at my own risk and confirm that the organisers shall not be held responsible for any loss, injury or damage that may occur as a result of my participation however caused. I confirm that I will be 15 years old or over by the day of the race, and if under 18 I have the permission of my parent or guardian. * By checking this box I understand and agree to all the above.