Registration for Pangbourne 10k - Your Way

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* 1. Your Name (The name used for donations or sponsorship)

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* 2. Which race are you entering?

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* 3. Postal Address (So we can send your medal or prize)

Street

Town

County

Postcode

Email Address

Phone Number

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* 4. I confirm I have read the health and safety guidance for the Pangbourne 10k Your Way. If I am registering for a child, I confirm I take responsibility for their safety during their run. I confirm I am happy that FOPPS will only store and use my personal data for the purposes of sending me my prize.

Yes

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* 5. I am happy for any photo or image I send to be used on the FOPPS website and social media sites.

Yes

No

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* 6. Please attach your photo or screengrab of your run. If you are entering a Speed category, this must include an image of the Pangbourne 10k Route and your time.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.