Nailsea Charity Walks and Runs 2023

Nailsea Charity Walks & Runs, 15 June 2025

Start from the Scotch Horn Centre car park from 8:30

Registration Form

Multiple Walks or Runs
For those keen enough and fit enough to take on two or three walks or runs, there is no need to register for each one. Simply register for one of them and contact the organiser at CharityWalks@rotarynailsea.org to let them know about the others.

1) Lead person making this registration

Name:*

Forename and surname

Email address:*

Email

example@example.com

May we include your email address in our database to notify future events that may interest you*

YesNo

Phone No. (mobile preferred):

2) Which charity / local community cause are you supporting?

Please select from the list below.

If you select "All", we will divide the money that you raise between all of the charities and local community organisations taking part in proportion to the number of walkers and runners for each one.

If you select any of the 3 Rotary Nailsea & Backwell headings, we will retain the money that you raise within the Rotary Club of Nailsea & Backwell Trust Fund for use for the purposes stated.

If the charity or local community organisation you wish to support is not listed, please select "Other - ...." at the end of the list and type the name in the box that will appear below.

Select charity from list:*

Enter your unlisted choice of charity/local community cause here:*

3) Please list ALL walkers and runners being registered on this one form below, up to a maximum of 10. Note that this INCLUDES the lead person if he or she is walking or running in this event.

For Junior entrants, who must be under 18 on 15th June 2025, please enter the Date of Birth.

Please note that children under 16 years of age should be accompanied by an adult.

For information on the routes please click here.

Entrant 1

Is this the lead person named above?

YesNo

Name:

Forename and Surname

Adult or Junior?*

AdultJunior

CountAdults1

CountJuniors1

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:*

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 2

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults2

CountJuniors2

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 3

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults3

CountJuniors3

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 4

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults4

CountJuniors4

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 5

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults5

CountJuniors5

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 6

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults6

CountJuniors6

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 7

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults7

CountJuniors7

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 8

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults8

CountJuniors8

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 9

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults9

CountJuniors9

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 10

Name:

Forename and Surname

Adult or Junior?

AdultJunior

CountAdults10

CountJuniors10

Date of birth:

Email address:

May we retain your email address in our database to notify future events that may interest you

YesNo

Which walk or run:

Do you expect to take part

on 15 Junelater (up to 31 July)

Estimated start time (if known):

e.g. 09.30

Payment

No. of Adults @ £10 each:

Total entry fee due (£):

No. of Juniors:

There is no fee for juniors but an optional donation to Rotary Nailsea & Backwell can be made in lieu of the registration fee.

Voluntary donation:

or enter your own amount (£):

Whole £ only please

I wish to Gift Aid my donation:

YesNo

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the
current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to
pay any difference.

Address (for Gift Aid)

Street Address and Town / City

Street Address Line 2

Post Code

Total due

Total amount due:

GBPRegistration fees and donation

Please review your form and then optionally print it or simply submit

Multiple Walks or Runs For those keen enough and fit enough to take on two or three walks or runs, there is no need to register for each one. Simply register for one of them and contact the organiser at CharityWalks@rotarynailsea.org to let them know about the others.

Multiple Walks or Runs
For those keen enough and fit enough to take on two or three walks or runs, there is no need to register for each one. Simply register for one of them and contact the organiser at CharityWalks@rotarynailsea.org to let them know about the others.