SFR 1 Person

Registration Form for 1

This registration form is for one paying participant.
You DO NOT need to register infants aged 0-4 years.
If you would like to register more than one participant, you will need to complete this form and pay for each person separately, or go back and select the correct number of participants.

Participant Contact Details

* Indicates required field

First Name *

Surname *

Address Line 1 *

Town/City *

County *

Postcode *

Email *

Daytime Telephone *

Evening Telephone *

Your Medical Details

Date of Birth *

Under 16s must be supervised by an adult throughout the run. Please give details below of the adult who will be responsible. Please note that the responsible adult must also register separately and take part in the run.

Parent/Carer First Name *

Parent/Carer Surname *

Parent/Carer Telephone Number *

Do you have any medical conditions that could be affected by your participation in this event? *

Yes No

If 'yes', please explain... *

Next of Kin

Next of Kin First Name *

Next of Kin Surname *

Relationship to Participant *

Next of Kin Telephone *

Next of Kin Mobile *

Your Superhero Team

If you are running with your family, or a group of friends who have registered seperately, please tell us their team name or the name of your team leader: *

Equality and Diversity

All the questions in this section are optional and will only be used for monitoring purposes. They may be shared with Havering Council, but will not be shared with any other third parties.

Gender *

Ethnicity *

If 'other', please state *

Do you consider yourself to have a disability? *

Yes No Prefer not to say

If 'yes', please explain *

Terms and Conditions of Entry

Booking:

Once booked, you will receive a payment confirmation email and a place confirmation email. If you do not receive your confirmation email within two working days please contact us immediately on 01708 734366 or by email to events@lennoxccf.org.uk.
Lennox Children's Cancer Fund reserves the right to cancel the event, or change the venue or date. In these circumstances, all efforts to communicate changes will be made, using the contact details given on the booking form above. It is the responsibility of the participant to check the email address submitted on the form up until, and on the day of the event to find out about any such changes.
Once booked, the registration fee is non-refundable. In the event that a participant can no longer take part, the place can be transferred to another participant up to one week before the event.
Lennox Children's Cancer Fund will not be liable to refund the registration fee in the event of cancellation due to war, fire, strike lock-out, industrial action, tempest, accident, civil disturbance or any other cause whatsoever beyond our control.

Health Conditions:

Participants are required to inform Lennox Children's Cancer Fund, in advance, of any injuries or medical conditions that may be affected by participation in this event. This includes, but is not limited to, asthma, diabetes, respiratory conditions and heart conditions.
If you have an injury, medical condition or if you are going to be pregnant at the time of the event, please contact us in advance on 01708 734366 or email events@lennoxccf.org.uk.

On The Day:

Please bring a valid photo ID with you on the day. We reserve the right to request proof of age or identity, and refuse entry if this cannot be given.
Fancy dress is always encouraged! However, please ensure that your costume is functional, without loose or sharp parts, and remember that you will get hot and sweaty!
Participants agree to abide by the event rules and to follow any instruction given by the marshals and Lennox representatives.
Lennox Children's Cancer Fund will not take any responsibility for lost or stolen items, or personal belongings. You are advised to leave all valuables at home or use a small bum bag to hold your valuables during the run.

Photography:

Participants may appear in photographs and/or videos taken during the event. By registering for this event, participants agree that any photographs and/or videos taken during the event can be used by the charity for future publicity. It is the responsibility of the participant to let us know, in advance, by email to events@lennoxccf.org.uk if he/she would like to be omitted from such publicity.

Payment/Sponsorship:

Participants agree to raise a minimum of £25 in sponsorship for Lennox Children's Cancer Fund. This should be raised in advance of the event and either given to a charity representative when signing in, or forwarded to the charity within two weeks after the event.

Declaration

Declaration *

I understand and agree to all the terms and conditions of entry. I agree to raise a minimum of £25 in sponsorship.

How did you hear about the Superhero Fun Run? *

If 'other', please explain... *

Registration Fee

The registration fee is £8 per person (free for 0-4 years) until 4th May 2018 (£10 per person thereafter) and includes:

Participation in the 5k Superhero Fun Run
A goody bag and medal upon completion
Free use of inflatables for participants aged 12 years and under

When you click 'Pay Now' below, you will be redirected to Paypal to complete payment of your registration fee. If you do not have a PayPal account, you will be able to checkout as a guest using your credit/debit card.

Submit and Pay Now