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Madmess 5K

Saturday 28th September, 2019
Introducing Madmess 5K. A mess of bubbles, glitter and paint - a fun run for all ages!

Booking Details

Participant Type: *
Adult £22.00
Address Line 1*
Address Line 2
Post Code*
Please separate your post code into the two boxes
Please confirm your email address*
Telephone No.*
Date of Birth*
Emergency contact name*
Relationship to you*
Emergency Telephone*
T-shirt size*
Please select a Madmess t-shirt
Select your wave*
Wave One starts at 11am (registration will open from 10am).
Wave Two starts at 12pm (registration will open from 11am).
Group name
Please enter your Group Name if you are taking part in a group.
Company name
Please enter your Company Name if you are taking part as a corporate team.
Medical Conditions*
Do you have any medical conditions we should be aware of? If you don't, please enter 'none' in the box.
In memory of
If you are taking part in memory of a loved one, please enter their name.
Relationship to you
How did you hear about this event?*
Contact by mail*
Contact by phone*
Contact by email*
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I confirm that I/my group wish to enter this event and understand that I/we do so at my/our own risk and that St Peter's Hospice will not accept liability for any injury or loss as a result of my/our participation but I/we understand that my/our statutory rights remain unaffected. I/we agree that I/we should seek medical advice from my/our general practitioner if I am/we are in any doubt as to my/our physical ability to participate in the event. By completing this form you are giving your permission for any photographs taken of you/your group to be used in future publicity. I understand that the entry fee I have paid for this event is non-refundable and non-transferable. I confirm I have read the terms and conditions for the event.