Registration Form
Organised by the Rotary Club of Taunton Vale

Note: Please make sure you scroll to the very bottom of the form

Team Name *
Your answer
Main contact *
(full name)
Your answer
If Corporate, name of business
Your answer
Address of main contact *
(contact for the whole team)
Your answer
Telephone number (home) *
(main contact)
Your answer
Telephone number (work)
(main contact)
Your answer
Telephone number (mobile) *
(main contact)
Your answer
Email address of main contact *
Your answer
Leader *
(full name and must be at least 17 years old)
Your answer
Entrant #2 *
(full name)
Your answer
Entrant #2 age if 16 and under
(see special entry conditions for 16's and under)
Your answer
Entrant #3 *
(full name)
Your answer
Entrant #3 age if 16 and under
(see special entry conditions for 16's and under)
Your answer
Entrant #4
(full name)
Your answer
Entrant #4 age if 16 and under
(see special entry conditions for 16's and under)
Your answer
Entrant #5
(full name)
Your answer
Entrant #5 age if 16 and under
(see special entry conditions for 16's and under)
Your answer
Entrant #6
(full name)
Your answer
Entrant #6 age if 16 and under
(see special entry conditions for 16's and under)
Your answer
Entrant #7
(full name)
Your answer
Entrant #7 age if 16 and under
(see special entry conditions for 16's and under)
Your answer
Entrant #8
(full name)
Your answer
Entrant #8 age if 16 and under
(see special entry conditions for 16's and under)
Your answer
Please choose which course and your preferred starting time
Course *
Time *
(starting times will allocated on a first come first served basis, please book early)
Fee due *
(£15 per person or £5 for under 16's)
Your answer
I have read the Entry Terms and Conditions *
Required
Two ways to pay
a) online bank transfer to 'Rotary Club of Taunton Vale Trust Fund', HSBC Taunton, Sortcode 40-44-04, Account number 71202812

b) cheques made payable to 'Rotary Club of Taunton Vale Trust Fund' and posted to 'Jas Shorney, Lyddons Mead, Nailsbourne, Taunton, TA2 8AF'

Entries will not be confirmed until payment is received.

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.