Email Address *

Mobile Phone *

Emergency Contact *

Name, Phone & Relationship

Pet Run Injuries

Describe your current run fitness

Run Speed Estimate

Please estimate the current time it would take you to complete a 10 km run race; Also indicate your personal best time. (indicate your 5km time if you don't know).

Do you intend to run any events significant to you in the next 6 - 9 months? Please list them below, with any time targets.

Run Fitness

Please indicate what your run fitness is at present so we have a starting point

Starting run fitness from scratch

Run 1-3 times per week, no up-tempo efforts

Run 2-4 times per week with reps included

Longest Run

Please indicate the length of your longest weekly run, at present

< 45 mins

45 - 60 mins

60 - 75 mins

> 75 mins

No

How did you hear about this group

Direct email from Jenny

Wellington Tri Club Website

Through a friend

Other - explain to Jenny when you see her

Waiver and Conditions

THESE CONDITIONS ARE HERE TO ENSURE TRACTION EVENTS ARE FUN, SAFE & THAT AVOIDABLE ISSUES ARE PREVENTED - PLEASE READ ALL CONDITIONS AND TICK THE BOX BELOW IF YOU ARE HAPPY TO ABIDE BY ALL CONDITIONS.

Refunds of payments made will be considered on a fair basis. If required please discuss with Jenny.

I ACKNOWLEDGE THAT PARTICIPATION IN TRACTION RUN TRAINING CARRIES WITH IT POTENTIAL RISKS AND HAZARDS, I UNDERSTAND AND ACKNOWLEDGE THAT THERE MAYBE RISKS RELATED TO RUNNING ON UNEVEN SURFACES SUCH AS TWISTING THE ANKLE & FALLING OVER. WE MAY CROSS ROADS WHERE WE HAVE TO BE AWARE OF INTERACTION WITH OTHER ROAD USERS. I TAKE RESPONSIBILITY FOR MY OWN WELL-BEING AND ACCEPT THAT I PARTICIPATE AT MY OWN RISK.

I understand that my contact details are included in the Traction Fitness database and that this database may be used for promotional purposes by Traction Fitness. I also agree that all images taken at Traction events can be used for promotional purposes without my written approval.

FOR MYSELF, HEIRS, NEXT OF KIN, SUCCESSORS AND ASSIGNS I HEREBY WAIVE AND RELEASE ANY AND ALL CLAIMS I MAY HAVE AGAINST TRACTION FITNESS, JENNY ROSE, ITS COACHES OR THEIR EXECUTERS, ARISING OUT OF MY PARTICIPATION IN THE RUN EVENTS AND ASSOCIATED ACTIVITIES, TOGETHER WITH ANY COSTS INCLUDING ATTORNEY'S FEES THAT MAY BE INCURRED AS A RESULT OF ANY SUCH CLAIM WHETHER VALID OR NOT

By ticking the box below I agree to the terms and conditions of this Traction Fitness Run programme *

Agree to terms & conditions

Payments

When paying can you please ensure you make it very clear who the payment is from i.e. J.Pearson. Call if you'd like to discuss.

Account Name & Number:

NJ ROSE - 02 0828 0088647 000 , Many thanks

Run Rego

Run Registration