Storm Running Registration Form
Title *
Your answer
First Name *
Your answer
Last Name *
Your answer
Gender *
Date of birth *
MM
/
DD
/
YYYY
House Number *
Your answer
Street Name *
Your answer
Town/City *
Your answer
Postcode *
Your answer
Email *
Your answer
Contact Number *
Your answer
Medical Information
Please detail below any important medical information that our leaders should be aware of (e.g. epilepsy, asthma, diabetes, allegies etc) Please do not leave blank - if there is no information please write 'None'.
*
Your answer
Emergency Contact Details
Please insert the information below to indicate the persons who should be contacted in the event of an incident/accident.
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Additional Information
How did you find out about Storm Running?
Your answer
Have you been a member of any other running club? If yes please name.
Your answer
Disability Category (Please tick one) *
Athlete Agreement
By completing this form, I confirm that I understand that participation in this group is entirely at my own risk and I should consult my doctor if suffering from any condition that might make running injurious to my health. I am willing to abide by the club code of conduct for athletes and agree to always behave in the manner befitting a STORM Runner, when training and attending events.

The code of conduct can be viewed here: http://bit.ly/2JcmVnt

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