CHASEWATER FAMILY FUN RUN 5K OR 1.2KM ROUTE AROUND CHASEWATER COUNTRY PARK Sunday 17th May 2015 Registration at the Chasewater Innovation Centre from 10.00am Runners set off at 10.30am. Entry Fee Runners £10, Walkers £5 and under 12’s free Come along and support the Royal British Legion The route of the run & walk is on grassland, tarmac and gravel footpaths. The organiser reserves the right to impose additional rules on the day, especially in bad weather. Commemorative medal to all who take part, T shirts for adult runners only. REGISTRATION FORM Name: ……………………………………………………………………………………………….. Address: ................................................................................................................................. .................................................................................................................................................. Post Code: .............................................. Telephone: ........................................................... Date of Birth: ............................................. Age on Race Day: ............................................ Please tick as appropriate. Run: Walk: (Cheques to be made payable to: The Royal British Legion) I declare that I will abide by the rules of the Poppy Run & Walk and I accept that the organisers will not be liable for any loss, damage, action, claim, costs or expenses which may arise in consequence of my participation in this event. I declare that I will not compete in this race unless I am in good health on the day of the race and that in any event, I will only enter at my own risk. I grant to The Royal British Legion, its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize The Royal British Legion its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that The Royal British Legion may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above: Signed: ........................................................................................... Date: ........................................................... All participants will be issued with a number; this will be ready for collection on the day. Please send completed registration forms with a cheques made payable to RBL to Freddy Homer, 24 St Johns Road, Essington, Wolverhampton, WV11 2BY.