Entry Form 2019
Please use this form to enter the 2 mile fun run. If you have not received your pack by the end of April please email admin@ptir.org.uk, Please do not reapply, as another running number will be allocated to you and may cause confusion at registration.

Please note you must pay an entry fee of £2 and raise a minimum sponsorship of £5 to take part in this event.

Last year we trusted entrants to pay their sponsor money in after the event. Many who took part did not pay us before the event and did not submit any monies after the event either! Therefore we must receive the entry fee and the minimum sponsor fee before or on the day of the event or you cannot take part.
We are very sorry to have to do this and hope that those who are dedicated to supporting us will continue to raise additional sponsorship for the charity which can also be paid in advance, on the day OR later. Please note that you can now submit your sponsor money on-line. See our website for more details

All proceeds will be split between Island charitable causes and the Paul Trigwell Memorial Fund which has been established to benefit underprivileged children.

Please Note;
> the 2 mile distance is approximate.
> If the entrant is under 18, consent is required from a parent or guardian. See the Consent section of this form.

Email address *
First Name *
Your answer
Surname *
Your answer
Address 1 *
Your answer
Address 2
Your answer
Town *
Your answer
County *
Your answer
Postcode *
Your answer
Telephone number
Your answer
Emergency Contact Telephone number *
This number must be reachable on event day
Your answer
Can we email you?
To keep our costs down please allow us to send you your pack and keep you updated by email. This will normally be within 72hrs. Please check this box if you do NOT wish us to email you. We will then post details to you. Please allow 7-10 days for this.
Date of Birth *
DD/MM/YYYY
MM
/
DD
/
YYYY
Age on event day *
Your answer
Gender *
Event Selection *
Please choose one event from the list below
Declaration
By agreeing below, I declare that I am medically fit to take part in this event and that I enter at my own risk. The organisers or any other party connected with this event will, in no way be held responsible for any injury or illness incurred before, during, or as a result of this event, or for any property.
Declaration Signed *
If you do not agree we cannot accept your entry form.
Consent Form
By agreeing this section I give permission for the under 18 named in this form to participate in the above event. I also give my permission if the necessity arises for my child to receive any medical treatment and if necessary for an anaesthetic to be administered.
Consent given
Given by
Please type your name and relationship to the entrant.
Your answer
Data Protection
None of your details will be forwarded to any third party. If you agree, we may pass your name only to the event photographer.
Data Signed *
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