MUD RUN SIGN UP - PARENTAL CONSENT

Dear Parents,

We would like to offer your child (age 13+) the opportunity to participate in an obstacle assault course mud run on June 20th. The run will take place in Dorking, Surrey and will include a wide range of challenging activities to enjoy, followed by a BBQ at the end. Transport to and from will be provided. In order to participate in this mud run, all runners must put down a deposit of £50 (payable via Achisomoch, charity voucher, bank transfer or cash) and raise a minimum of £450.

Please fill in the following form in order to give your child consent to participate in this mud run. Once this is done, we will send out an email with further details.

We look forward to having your child involved in this very worthwhile cause.

For any questions please call 

Yael Forta-07956436369
Avigayil Gilbert-07787225419
Tsivya Le Blanc-07391012576

Kind Regards


RUNNERS DETAILS
























T-SHIRTS We will be ordering t-shirts. Please select your size preference (XS S M L XL XXL):

MEDICAL INFORMATION















PARENTAL AGREEMENT

In order to participate in the mud run all runners must pay a deposit of £50 (refundable upon reaching target of £450). Runners must reach the following goal in order to secure their participation on this mud run:

  • 15th May: £250
  • 15th June: £400
Failure to meet any of the above could result in automatic removal from the mud run.







Rules and regulations - I confirm that the attached rules and regulations have been discussed with my daughter.

Parent signature (draw with mouse or finger):


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