Medway Mile - Sign Up

Medway Mile registration form

To take part in this year's Medway Mile please complete the form below

Please fill in all fields marked *

Name *

Address *

Postcode *

Daytime telephone *

Evening telephone

Email address *

Age on race day (years) *

If under 16 Name of parent or guardian
Emergency contact number

Gender *

Male Female

Do you plan to run or walk the mile? *

Run Walk

Are you a member of a local sports club?

If so, which one.

Medway Council might like to contact you in the future about possible events and volunteering opportunities and send you the Medway 2012 newsletter. If you are not happy for this to happen, please tick here.

Declaration

I understand and agree that I participate in this event entirely at my own risk. I agree that no liability shall be attached to the organisers or any promoter or sponsor. I accept that the organisers will not be liable for any loss, damage, action, claim, costs or expenses which may arise as a consequence of my participation in this event. I declare that I will not take part in this event unless I am in good health on the day of the race and that I will only take part at my own risk. I also understand that the event will be recorded, photographed and filmed for legitimate purposes.