First Name *

    Last Name *

    Email Address *

    Firm / Company *

    Profession *

    Mobile Phone *

    Company Address: If a family member or friend also wants to participate, a separate form will have to be filled out. They should fill in their personal address when registering. If you are bringing along young children, you do not have to register them. *

    Address 2 *

    Address 3

    DX Number

    What distance are you running/walking? If you decide to switch distances, you will need to inform us beforehand and not on the day of the event. *

    Are you entering the Firm Team Challenge? Please remember to fill in your team name. *

    How did you hear about the run? *


    Please tick this box if you do not wish to receive our newsletters which contain important information about the run