REGISTRATION
FORM

Premium

RUNNER DETAILS

Complete each runner’s details before continuing to checkout.

QUANTITY

RUNNER 1

RACE *

FIRST NAME *

LAST NAME *

FATHER NAME *

YEAR OF BIRTH *

GENDER *

T-SHIRT SIZE *

EMERGENCY PHONE *

RUNNER 2

RACE *

FIRST NAME *

LAST NAME *

FATHER NAME *

YEAR OF BIRTH *

GENDER *

T-SHIRT SIZE *

EMERGENCY PHONE *

1.5KM 5KM 10KM Premium