The Purbeck 10K +

The Purbeck 10k + Entry Form - 2019

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• Name*
  First Last
• Gender*
  Please ChooseMaleFemale
• Age on 15-09-2019*
• Date of birth*
  DD

  MM

  YYYY
• Email*
• Post Code*
  Street Address Address Line 2 City County / State / Region ZIP / Postal Code

• T Shirt not included in the entry fee.*
  Please ChooseI'd like to order a T shirt at £8 extraNo thanks.
  A T shirt is not included in the entry fee. If you would like to purchase below please select below.
• What size T-Shirt would you like?*
  • Xtra Small
  • Small
  • Medium
  • Large
  • Xtra Large

• Are you a member of an affilliated club?*
  NoYes
• Affiliated club
• UKA Affiliation Number
• Team name (opt)
• Your Phone Number*
• Emergency Contact Name*
  First Last
• Emergency Contact Phone Number*
• Where did you hear about The Purbeck Marathon?
  • Runners World Website
  • Our Website
  • Other website
  • Running magazine
  • Other press
  • Other
• Race Instructions and Terms and Conditions*
  Please confirm that you have read our Race Instructions and our Terms and Conditions of entry? http://thepurbeckrunningfestival.co.uk/
  • Yes
• Please confirm that you are aware that The Purbeck 10k + is a bit more than 10k - hence the '+'.*
  • Yes
• Any additional comments or information you wish to pass on to the race organiser
• I DECLARE that on race day I will be fit to compete and over 15 years of age and will abide by the UK Athletics rules for competition. I accept that the organisers shall not be liable for any injury, illness or accidents as a consequence of my participation in this event. I will abide with the rules governing this event. I will carefully read all information sent to me prior to the event and I understand that this is a challenging, predominantly off-road event.*
  • Please tick to confirm

• Purbeck 10K + Entry fee*
  Affiliated £16.00
  Affiliated
• Purbeck 10K + Entry Fee*
  Unaffiliated £18.00
  Unaffiliated Entry Fee
• Purbeck 10K + T Shirt Fee*
  T Shirt @ £8
  Not expecting to see this? You can use the 'Previous' button to go back and change your choice.
• ENTER DISCOUNT CODES HERE
  
• By using this form you agree with the storage and handling of your data by this website.*
  • I Agree

• Admin fee £2
  £ 2.00
  This fee covers the costs and administration of online transactions.
• Total
  £ 0.00
• Credit Card*
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• Thank you for choosing to run The Purbeck 10k. You will shortly receive a confirmation email with further information. Good luck with your training and we'll see you on the 15th September 2019.
• Email
  This field is for validation purposes and should be left unchanged.