Volunteer Request Form First Name * Surname * Gender * Male Female Club Name (if applicable) Date of Birth Day * 01020304050607080910111213141516171819202122232425262728293031 Month * JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year * 193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016 Email Address * Preferred Contact Number * Mobile Number Property Name / Number * Street Town County * Post Code * Event Details Event * Please select...5K2K Fun Run10K5 MileBeginners AquathlonAquathlon ChallengeJunior Taster AquathlonBeginners TriathlonSprint TriathlonJunior Taster TriathlonGlow Walk & Fun RunBeginners DuathlonDuathlon ChallengeJunior Taster DuathlonSanta DashJunior Santa Dash Time or Estimated Time for 80m Swim * Time or Estimated Time for 100m Swim * Time or Estimated Time for 200m Swim * Time or Estimated Time for 400m Swim * Are you a British Triathlon Federation Member (BTF)? * Yes No BTF Membership Number * Please note that for insurance purposes you are required to hold a BTF (British Triathlon Federation) membership on the day of the event. As an existing BTF member you will not be required to pay for a day membership as your existing membership to the BTF will provide your event insurance. Please bring your membership card as proof of membership on the day of the event. Please note that for insurance purposes you are required to hold a BTF (British Triathlon Federation) membership on the day of the event. As a non BTF member you are required to purchase a day membership to provide your event insurance. Your day membership will be included in your total event fee and a copy will be emailed to you in advance of the event. Are you a UK Athletics affiliated runner? * Yes No UKA Membership Number * Have you participated in a LLeisure Event before? * Yes No Do you have any medical or disability information we need to be aware of? * Yes No Your medical or disability information * Where did you hear about this course? * Please select...BannerFlyer at a Sports CentreFacebookTwitterFlyer Generally AvailableLeaflet through LetterboxLocal NewspaperThrough my ClubWeb SearchWord of MouthMailing ListBlog Why are you taking part in the event? * Please select...New ChallengeGet FitImprove HealthSocialFunSomething DifferentJust Another Event Opportunity If you would like to opt in to receive advanced notice of LLeisure activities please tick here * I agree to the LLeisure Sports Events Terms and Conditions This information will be used in accordance with our privacy notice. Please see our website for full details here If you are human, leave this field blank.