Additional athlete information

Full name of person who placed the booking:: *

Original order number: *

The order number from the original booking.

First name: *

Last name: *

Additional guest information

Age group: *

Date of birth: *

Sex: *

(TRIATHLON) 400m Swim Time:

(DUATHLON) 5K Run time:

Are you a BTF/England Athletics licence holder?: *

If yes please supply your BTF/AE license number:

Triathlon club/organisation name:

If you are entering a team what is it's name?:

Do you have any medical conditions or disabilities?: *

If so please list the conditions and/or disabilities:

Emergency contact name: *

Emergency contact phone number: *

Please tick to state you agree with our terms and conditions: *

Yes