First Name* | |
Last Name* | |
Gender* | |
Email* | |
Date of Birth* | DD/MM/YYYY format (e.g. 28/10/1980) |
Mobile Phone* | Your primary contact number |
Athletics/Running Club | |
Corporate Team Name | |
T Shirt Size* | |
Number of Events* | Estimated number of races you plan to run |
Athletics NI Athlete Registration Number | |
Athletics Ireland Athlete Registration Number | |
Validation* | 7 × 2 = ? |
Consent to Marketing* | I consent to receiving CANCOM 10K Grand Prix updates and communications from ChampionChip Ireland and CANCOM |