LLHM registration form Form

Sponsored Runner Registration

Please fill the form below, you will then be added to the LLHM portal and will need to complete the registration process directly with them. Once this has been done the details can not be changed so by completing the portal registration you are committing to running on behalf of Quetzal and raising a minimum of £250 for the charity.
Name:*

First NameMiddle NameLast Name
Birth Date

MonthDayYear
E-mail Address:
Phone Number

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityCounty

Post codeCountry
About You
Have you run a half marathon before? Would you like information about training plans?*
Would you like a Quetzal t-shirt to wear during the run?
prevnext( X )
Quetzal T-shirt$ Free

T-Shirt

Total $0.00
Please confirm that you understand you are responsible for ensuring you are well enough to take part. You should consult a doctor if you have any underlying health conditions that could affect your ability to run.*
Please confirm you are aware that travel to and from the event is not provided by Quetzal*
Please confirm you are willing and able to raise a minimum of £250 for Quetzal *
Fundraising support will be provided
Signature*

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Sponsored Runner Registration