Rotary Canal Challenge Registration Form
Organised by the Rotary Club of Taunton Vale.

If you've been sent this Form by email please go to our website TauntonValeRotary.org.uk to ensure you have all the information and have read both the "Terms & Conditions" and the "Health & Safety through Covid-19". You can also complete the Form from the website "Enter Online".

Note: Please make sure you scroll to the very bottom of this form answering all the questions. Then 'sign' your name at the end. We look forward to seeing you on the night
Email *
What activity are you planning? *
(full name)
What distance are you planning? *
(full name)
Main contact/group leader - this name will be used to contact your group on the day. You must be 17 years or older *
(full name)
If Corporate, name of business
Email address of main contact *
Mobile Telephone number of main contact - this number will be used to contact your group *
Entrant #2 *
Full name (and age if under 17)
Entrant #3 *
Full name (and age if under 17)
Entrant #4 *
Full name (and age if under 17)
Entrant #5
Full name (and age if under 17)
Entrant #6
Full name (and age if under 17)
Please choose your preferred course and starting time
Course *
Time *
(starting times will be allocated on a first come first served basis following payment of fees, please book early)
Fee due *
(£20 per person or £5 for under 16's) Please be aware that should the situation change entry fees will be fully refunded.
Permissions
I give permission for any photos taken of me or my team to be used for the future promotion of Moonraker or Rotary purposes. These images will not be made available to any person or organisation outside of Rotary Club of Taunton Vale
By entering my name I confirm I have read and agree to the 'Terms and Conditions' and the 'Health & Safety through Covid-19' and that I have permission to sign on behalf of all members of my Team. *
Entry cannot be confirmed until payment is received. *
Please pay all fees online to 'Rotary Club of Taunton Vale Trust Fund' HSBC - sort code 40-44-04 - Account 71202812 using your Team Name as a reference.
Entry cannot be confirmed until payment is received.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.