Nailsea Charity 5K 2026 - Registration Form

Nailsea Charity 5K, 7 June 2026

Start from the Scotch Horn Centre, Nailsea from 9:00

Registration Form

1) Lead person making this registration

Name:*

Forename and surname

Email address:*

Email

example@example.com

YesNo

Phone No. (mobile preferred):

Format: 00000 000000.

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 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 7th June 2026, 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

YesNo

Name:

Forename and Surname

AdultJunior

CountAdults1

CountJuniors1

Date of birth:

Email address:

YesNo

Which walk or run:*

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 2

Name:

Forename and Surname

AdultJunior

CountAdults2

CountJuniors2

Date of birth:

Email address:

YesNo

Which walk or run:

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 3

Name:

Forename and Surname

AdultJunior

CountAdults3

CountJuniors3

Date of birth:

Email address:

YesNo

Which walk or run:

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 4

Name:

Forename and Surname

AdultJunior

CountAdults4

CountJuniors4

Date of birth:

Email address:

YesNo

Which walk or run:

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 5

Name:

Forename and Surname

AdultJunior

CountAdults5

CountJuniors5

Date of birth:

Email address:

YesNo

Which walk or run:

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 6

Name:

Forename and Surname

AdultJunior

CountAdults6

CountJuniors6

Date of birth:

Email address:

YesNo

Which walk or run:

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 7

Name:

Forename and Surname

AdultJunior

CountAdults7

CountJuniors7

Date of birth:

Email address:

YesNo

Which walk or run:

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 8

Name:

Forename and Surname

AdultJunior

CountAdults8

CountJuniors8

Date of birth:

Email address:

YesNo

Which walk or run:

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

AdultJunior

CountAdults9

CountJuniors9

Date of birth:

Email address:

YesNo

Which walk or run:

on 7 Junelater (up to 30 June)

Estimated start time (if known):

e.g. 09.30

Do you wish to add another entrant?

Entrant 10

Name:

Forename and Surname

AdultJunior

CountAdults10

CountJuniors10

Date of birth:

Email address:

YesNo

Which walk or run:

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

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

GBP

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