Sport Systems

Chiltern Chase 15K, 10K & 5K

Information marked * is mandatory

Participant Details

Club or Team

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Contact Details


Emergency Contact Details

In case of an emergency, please provide contact details of someone who IS NOT running


Please accept this entry for the Chiltern Chase 15k on 4 June 2017. I will be 16 years of age or over on race day and I confirm that I am medically fit to compete. I also declare that I have no medical disabilities that will endanger me or others participating in the event. I accept that I enter at my own risk and that the organisers and sponsors will in no way be held responsible for any personal injury, or loss or damage to property before, during or after the event. I understand and accept that the organisers reserve the right to cancel the race if adverse weather should make conditions too dangerous for competitors, or a serious incident occurs that prevents the race going ahead. In this event, there will be NO REFUNDS. I also accept that if I am entering this race on behalf of another person, I am authorised by them to accept these Terms and Conditions on their behalf. I will also take the responsibility to ensure that they are aware of any further information provided about this race e.g. confirmation and race information emails. I understand that I have a legal responsibility to ensure all sponsorship money/donations received by me are paid to the relevant charity. I also confirm that if I am under 18 years of age on race day, I have the permission of my parent or guardian to take part in this race and I have included their contact details below

Parent/Guardian Details must be provided if the entrant is under 18 on race day

Data Protection

The personal information gathered by Sport Systems when you place your order will only be used for the purpose of administering the event. This could be by Sport Systems, the race organisers, or any appointed third party, such as an official photographer, or a different race timer. Certain details such as your name, age and running club, but not contact data, may appear on various results websites, results emails, text messages and could even appear in newspapers. We may also use your details to keep you informed about future events, unless you have ticked the box in the “Submit Entry” section, to opt out of receiving news of offers and forthcoming events, with which Sport Systems is involved.

* Yes I Agree


The race is raising funds for South Central Ambulance Charity and The Friends of Ewelme School. We would be delighted if you can fundraise for us but if you are unable then you may like to consider making a donation. Don’t forget to check the Gift Aid box if you are a UK tax payer as we can reclaim the tax on your donation.


* I wish to Gift Aid this donation. 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.

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