Buscot Run Application

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Name* This field is required.First Runner

First Name

Last Name

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Choose 5k or 10k* This field is required.

5k

10k

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Name (Second Runner)Second Runner, if applicable from same address

First Name

Last Name

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Choose 5k or 10k

5k

10k

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Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Email* This field is required.

example@example.com

Confirm Email

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Preferred Phone Number

Area Code

Phone Number

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Date of Birth* This field is required.First Runner

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Please answer the following questions* This field is required.Answer those that apply first Runner

Male

Female

Under 16 on 29th June 2019

GDPR, we will not share you information with any third party.

You agree that we can send you an automated receipt

You would like to be contacted when the arrangements have been made for the 2020 Buscot Run

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Date of BirthSecond Runner

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Please answer the following questions (Second Runner)Answer those that apply Second Runner if applicable

Male

Female

Under 16 on 29th June 2019

GDPR, we will not share you information with any third party.

You would like to be contacted when the arrangements have been made for the 2020 Buscot Run

Other

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By entering this event, I agree that I will only take part on the day if I am in good health and have undertaken adequate training for the distance I am running.
I understand that the organisers will take reasonable steps to promote my safety and that I must comply with all instructions given by the race organisers and marshalls.

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Emergency Contact details* This field is required.Please enter name and contact telephone number

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Signaturee-signature for online applications. Main runner only

Clear

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Thank you for your application to join the Buscot Run 30th June 2019.

If you would like any further information prior to the date please email roddybenson@gmail.com or info@faringdonrotaryclub.org

We are looking forward to seeing you on the day.

Please continue to payment

Best Regards

Rodney Benson

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Buscot Run Payments

My Bag

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Faringdon Rotary Club Buscot Run 10k
£15.00Edit
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Buscot Run
Subtotal: £0.00
Faringdon Rotary Club Buscot Run 5k
£10.00Edit
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Quantity
Faringdon Rotary Club Buscot Run under 16's
£7.00Edit
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Charity Donation
£1.00Edit
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Organiser: Rodney Benson, 2 Carters Cresent, Faringdon, Oxfordshire, SN7 LA

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Email

example@example.com

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Type a questionPlease enter a contact name and phone number

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