MINI PG100, 5k & 10k Registration

By selecting this box, you are indicating that you are the parent/guardian of the person you are about to register. Additionally, if the child is under the age of 13, you are consenting to the collection and use of the information about the child for the purpose of the registration for this event.

Registrant Name

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Address

Address 1

Address 2

City

ZIP / Postal Code

Email Address

(Parent/Guardian's if U18)

Mobile Number

Event

Mini PG100

5K Walk/Run

10K Run

Not Liable

I understand that the organisers will not be liable for any loss, damage or injury whatsoever directly or indirectly occasioned by or resulting from the negligence, wrongful act, or the fault of the organisers of Friends of Portglenone GAC or any act of God or physical condition of the entrant.

PG100

Cycle Registration
MINI PG100, 5k & 10k Registration
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