Personal Details
First Name:
Surname:
Address1:
Address2:
Town:
County:
Country:
PostCode:
Email:
Mobile Phone:
Alternate Phone:
Date of Birth:
Age on Race Day:
Gender Male    Female
AAA club (if affiliated)
   

Race Entry
Half Marathon – AAA affiliated

£26.50
Half Marathon – non-AAA affiliated

£28.50
Marathon – AAA affiliated

£30.00
Marathon – non-AAA affiliated

£32.00
Wheelchair Half Marathon

£10.00
Unemployed Entry - Half Marathon

£20.00
Unemployed Entry - Marathon

£20.00
Late entries after 20/8/10
(excl Mini-Marathon)

Add £5.00

   
Experian Mini-Marathon

£6.75
School attended if under 17 years of age
   
Official T-shirt

New Balance
moisture management race t-shirt
£13 including p&p

 Small
Medium
Large
X Large
   
Charity Donations
Optional donation to Leukaemia Research and Treetops Hospice, Nottingham & Derbyshire’s local hospice. £5.00
£10.00
Other
Gift Aid To tick Gift Aid you must be a UK tax payer paying an amount of tax equal to the tax reclaimed by the charity on the donation
   
Total Payment
   
Are you raising funds for charity? If so, which one
Estimated amount   
   
If you would like to receive a fundraising pack from any of the Official Charities please select your choice(s) below:
   
Leukaemia Research  
Treetops Hospice  
   
Select this box if this is your debut at the distance 
   
Estimated finish time H M S
 
Select this box if you wish to receive information on running related products and future events
 

Runner Declaration. A ChampionChip timing device will be used in the Marathon and Half Marathon. If you decide not to run, these must be returned. Competitors must be over the age of 18 for the Marathon, 17 for the Half Marathon and any child under 11 in the Fun Run must be accompanied by a responsible adult. Completing this entry form will be considered a declaration that you will run entirely at your own risk and that you have no medical disabilities that would endanger you or others taking part.

You understand the organisers reserve the right to alter the arrangements and conditions should circumstances require. Entries are not refundable.

Overseas competitors should contact the Race HQ to notify them of a UK forwarding address or their race packs will be held to be collected from the Race Help Desk on Race Day.