Basic Information

Please only complete this form if you are a national or regional winner of an ESU IPSC feeder competition, and will be attending the IPSC week in London in May 2024. Please note that the ESU London is unable to cover any travel costs to or from the IPSC week, and we are not able to cover accommodation or travel costs for any accompanying guests. Should this present an issue please speak directly to your local ESU representative for support. 

International ESUs and Partner Organisations will be sent information on how to register any accompanying guests separately.

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* 1. First Name(s) /Given Name(s):

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* 2. Surname(s) / Family Name(s):

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* 3. Preferred name for use in the competition

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* 4. Date of Birth

Date

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* 5. Which country/region will you be representing?

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* 6. What is your email address?

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* 7. Which gender do you identify as?

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* 8. Please provide any dietary requirements

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* 9. Do you have any allergies or medical needs we need to be aware of? Please detail any allergy medication you may be required to take, or any specific medical or other needs which we will need to take into account when planning the week and ensuring you can participate fully

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* 10. Please provide the name of an emergency contact

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* 11. What relationship is your emergency contact to you?

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* 12. Please provide a contact telephone number for your emergency contact

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* 13. Please provide a contact email address for your emergency contact