Plas Heli

The Welsh National Sailing Academy and Events Centre .

Cymraeg

5K & 10K - Plas Heli Medi 2019

Form for the 10K 5K Plas Heli Run on 15th September 2019

Your Name(*)

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Address(*)

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Postcode

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Telephone Number(*)

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Mobile Number

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Email(*)

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Date of Birth

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Emergency Contact Details(*)

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Medical Conditions

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You can enter more competitors on the same form. One form for the whole family
The 'contact details' and the 'emergency contact details' of the first name competitor (above) will apply to all subsequent competitors. If you prefer to have separate details please use a separate form.

More Competitors (*)

No - If answered 'No' - Please move on to the next pageYes - If you answered 'Yes' - please provide the information required in this section. Invalid Input

Second Competitor Name(*)

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Date of Birth Competiitor 2

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Medical Conditions for Competitor 2

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Third Competitor Name(*)

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Date of Birth Competiitor 3

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Medical Conditions for Competitor 3

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Fourth Competitor Name(*)

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Date of Birth Competiitor 4

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Medical Conditions for Competitor 4

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Fith Competitor Name(*)

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Date of Birth Competiitor 5

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Medical Conditions for Competitor 5

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CONDITIONS

Amendment or cancellation of this booking can only be made in writing or by email (not by telephone), which will be acknowledged in writing or by email as received by Plas Heli. If amendment or cancellation is made within two weeks of the arrival date up 100% of the fees may be charged. The person booking must ensure that he/ she has read and fully understands the Plas Heli Rules and Regulations which will be adhered to at all times.

Consent (*)

I consent to the above details being kept on the Plas Heli computer and paper file for the purpose contact, receiving relevant information. Invalid Input

Plas Heli Cyf will not accept any liability for personal injury arising out of the use of this facility either sustained by staff, their guests or visitors whether or not such damage or injury could have been attributed to or was occasioned by the neglect, default or negligence of Plas Heli, other visitor, servants or agents of either organisation.

Terms & Conditions(*)

I agree to the Plas Heli Facility Terms and conditions that are published on the Plas Heli Website. Invalid Input

10K Competitors(*)

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5K Competitors(*)

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1K Competitors(*)

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Donation to Access All Areas

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Total

0.00 GBP

Please confirm your booking - this will take you to a Pay Pal page where you can pay with your bank card. The booking is not confirmed until we (and you) receive a confirmation of payment

Registration Date

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Proceed to Payment

For Admin Use

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10K 5K Sponsors

Contact Information

Plas Heli Cyf Glany Don, Pwllheli, Gwynedd LL53 5YT

Bar: 01758 614 442
Office: 01758 613 343

Company Registration No. 08082514
VAT No. GB 164061430