Muslim Charity Run 2017
Please complete the registration form to participate in 'Muslim Charity Run'. You must answer all of the questions which apply to you.

What is your First Name?
Please enter your name below.
Your answer
What is your Surname?
Please enter your name below.
Your answer
Home Address
Please enter your full home address below.
Your answer
Postcode
Please enter your postcode.
Your answer
Telephone
Please enter your telephone.
Your answer
Email
Please enter your email address.
Your answer
Age
Please enter your age.
Your answer
What is your T-shirt Size?
Please provide us with your t-shirt size so we can have a t-shirt available in your size!
Choose a charity
Please select the charity you wish to run for.
Charity Name
Emergency Contact
Next of Kin Name
Please enter the name of a family member or close relative.
Your answer
Next of Kin Telephone
Please enter next of kin telephone number.
Your answer
Health Details
It is the responsibility of the runner to be fit to compete on the day of the run. If you have any medical issues which you think may put you at risk when running, see your GP prior to commencing on a training programme.
Do you have any disabilities?
Please enter details of any disabilities.
Your answer
Your Health Status
Please select your current health status
Do you have any of the following conditions?
Please select the issues that apply.
Other Condition
Please explain the condition below.
Your answer
Terms & Conditions
1. You must be able to finish the race in 2 hours or under. 2. Runners must compete on foot. 3. You understand that you are participating entirely at your own risk. 4. The East London Mosque Trust (ELMT) nor its sponsors and suppliers, including local authorities and facilitating agencies be liable for any loss, damage, illness or injury whatsoever directly or indirectly occasioned by or resulting from the negligence, wrongful act or default of ELMT, its sponsors, suppliers and facilitating local authorities and agencies or thier respective servants or agents from any other cause, including any act of God or the physical condition of the runner. 5. The ELMT reserves the right at its absolute discretion to alter the date of the event or to change the published course as deemed necessary at any time and to alter without prior notice the contents of each race pack and the event media partners.
Agreement
Please explain the condition below.
Required
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