Welcome to the RHAC Couch to 5k Course
   Application for the next course

Forename(s) and surname of person concerned

person concerned- date of birth and gender

Name and contact number of your
next of kin or emergency contact

your phone number

email address: important for contact

Important: any medical information you wish to be known
(leave blank if none)

I have read and understood the 'Data Protection and Storage Policy' for Couch-t0-5k Applicants and agree that the data I supply may be used by the club for the purposes
described in the document

Please complete the brief details requested above so that we can guide your application more clearly. Any emergency or medical information you supply is in confidence.

Click on yellow to check your entry.......
.... when it's OK click on 'proceed' which will have turned green

Please make sure your email address is correct (as we use email for all contacts etc)
If you change your email address, please let us know
If you have any special circumstances and need advice, contact the course organisers in confidence.