Humber Half Marathon

PERSONAL DETAILS

Title Address*

Surname*

First Name*

Gender MaleFemale

Date of Birth * Age Post Code*

Telephone* Where did you hear
about us?

E-Mail*

ENTRY DETAILS

(A) HUMBER BRIDGE HALF MARATHON (Note: Entrants must be 17 years of Age or older on race day)
Estimated Half Marathon Time (Minutes)
T-shirt size	Small Medium Large
(i). PEARSON PARK HOTEL TEAM CHALLENGE
Team Name
(ii). I AM A MEMBER OF A UK ATHLETICS AFFILIATED CLUB
Club Name
Number
(B) FAMILY FUN RUN (Note: Children under 8 years of age must be accompanied by a responsible adult.)

DECLARATION (For Completion by all runners)
I wish to enter the 'Humber-Half' Marathon/Family Fun Run and hereby certify that I am amateur as defined by the BAF Laws and that I am medically fit to run the chosen distance.I certify that I understand and agree that the Organisers will not, in any way, be responsible for any injury, illness or damage to my person or possessions during or as result of my participation in the event and that as a competitor in the Half Marathon I will be 17 years or older on the day of the event I AGREE I DO NOT AGREE
If you are taking part for a special reason, perhaps in memory of a loved one, or as a personal challenge. We would like to hear about your story. Please give brief details.

PAYMENT DETAILS

Half Marathon(unaffiliated)

£20.00

Half Marathon(affiliated to a club)

£18.00

Family Fun Run

£5.00

Donation to our chosen charities
(Dovehouse Hospice, Cash for Kids, When you wish upon a star)

Total £

Make your donation go further: if you have made a donation to our chosen charities, we can claim Tax on it if you complete the Declaration below.

I am UK Tax Payer and want the donation to be treated as a donation made under the Gift Aid Act Scheme.

Full Name

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