To register your family for The Family Mile, please complete this form with the details of the lead family member who will be the main point of contact for your family.

Details of other family members that you would like to register can be entered in section 12.

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* 1. First Name 

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* 2. Surname

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* 3. Postcode

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* 4. Are you a Golding Homes tenant?

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* 5. Email Address 

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* 6. Mobile Number 

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* 7. Age

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* 8. Gender

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* 9. Ethnicity

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* 10. Do you or any other participating family members have a disability?

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* 11. Please enter names/ages/genders of all other participating family members

e.g. Joe/12/male

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* 12. How often do you do physical activity as a family?

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* 13. Do you or any members of your family that you are registering for The Family Mile have any long term illness, health problems, disability or anything else that limits your daily activity?

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* 14. How did you find out about the Family Mile?

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* 15. Under the GDPR (data protection) act we need permission to share your data. Sports England, Brunel University and The Mason Foundation will only use/store your data for the purpose of monitoring & reporting on The Family Mile programme.

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* 16. Tick below to declare that all the above information is correct. You understand you may be asked to seek medical advice if required. You must inform The Family Mile of any changes in your health. You participate in the activity at your own risk.

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