Three Legged Race - IsleListen

Register For The Isle Listen Three-Legged Race

* indicates required fields

For participants under the age of 18, this form must be completed by a parent or responsible adult. Please note, by completing this form on behalf of an under 18 you agree there is parental consent for them to take part in the Three-Legged Race.

Team Email Address*

Team Phone Number*

Participant 1 Full Name*

Participant 1 Age at Time of Event*

Please note:
Participants aged 5, 6 or 7 must be paired with an adult 18+.

Participant 1 Emergency Contact (Full Name)*

If the participant is under 18 this contact should be their parent or carer.

Participant 1 Emergency Contact (Phone Number)*

Participant 1: Medical Declaration

Please indicate any medical conditions we should be aware of. Please note participating in this event is entirely at your own risk.

Participant 1: Under 18 Photographic Consent*

Yes: I do give photographic consent for my child

No: I do not give photographic consent for my child

Isle Listen will take photographs at the event for the purpose of marketing the event on social media and Isle Listen’s website. If you do not consent to photographs being taken of your child please make your child known to us on the day of the event so that we can take steps to identify your child in order to exclude them from photographs.

Participant 2 Full Name*

Participant 2 Age at Time of Event*

As participant 1 is 5, 6 or 7 they must be accompanied by an adult 18+.

Participant 2 Age at Time of Event*

Participant 2 Emergency Contact (Full Name)*

If the participant is under 18 this contact should be their parent or carer.

Participant 2 Emergency Contact (Phone Number)*

Participant 2: Medical Declaration

Please indicate any medical conditions we should be aware of. Please note participating in this event is entirely at your own risk.

Participant 2: Under 18 Photographic Consent*

Yes: I do give photographic consent for my child

No: I do not give photographic consent for my child

Where Did You Hear About the Three-Legged Race?*

Please State:

I Would Like To Receive Occasional Emails About The Work of Your Charity*

Yes

You can opt out of receiving communications from us by clicking the unsubscribe link in our marketing communications. Our Privacy Policy provides more information about how and why we use your personal data.

Team Type*

Two Adults

Adult and Child Under 10

Two Children 8-10

Checkout Total

Payment Method*

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

I will be bound by the Terms and Conditions of the Isle Listen Three-Legged Race, adhering to all safety instructions provided at the time of the event. I also confirm that I am participating entirely at my own risk and that I will participate in a manner that is safe. I confirm that if I am registering a team on behalf of participants under the age of 18 that I have obtained or given parental consent for them to take part.*

By checking this box I confirm that:

Team ID

How your support helps our local community

Isle Listen

Isle Listen is a trading name of MCH Psychological Services, an Isle of Man registered charity with over 40 years’ experience of providing emotional and psychological support.

Isle Listen’s charitable work focuses on a preventative mental health education programme for young people on the Isle of Man. This programme currently operates in 95% of the Island’s schools & UCM. Isle Listen is in the process of expanding into the community and onto an eLearning platform. Through work commissioned by Manx Care, Isle Listen also provides vital one-to-one therapeutic mental health support to young people up to 18 years of age. This service is led by qualified and accredited therapists.

Register For The Isle Listen Three-Legged Race

* indicates required fields

Team Email Address*

Team Phone Number*

Participant 1 Full Name*

Participant 1 Age at Time of Event*

Please note:
Participants aged 5, 6 or 7 must be paired with an adult 18+.

Participant 1 Emergency Contact (Full Name)*

If the participant is under 18 this contact should be their parent or carer.

Participant 1 Emergency Contact (Phone Number)*

Participant 1: Medical Declaration

Please indicate any medical conditions we should be aware of. Please note participating in this event is entirely at your own risk.

Participant 1: Under 18 Photographic Consent*

Yes: I do give photographic consent for my child

No: I do not give photographic consent for my child

Participant 2 Full Name*

Participant 2 Age at Time of Event*

As participant 1 is 5, 6 or 7 they must be accompanied by an adult 18+.

Participant 2 Age at Time of Event*

Participant 2 Emergency Contact (Full Name)*

If the participant is under 18 this contact should be their parent or carer.

Participant 2 Emergency Contact (Phone Number)*

Participant 2: Medical Declaration

Please indicate any medical conditions we should be aware of. Please note participating in this event is entirely at your own risk.

Participant 2: Under 18 Photographic Consent*

Yes: I do give photographic consent for my child

No: I do not give photographic consent for my child

Where Did You Hear About the Three-Legged Race?*

Please State:

I Would Like To Receive Occasional Emails About The Work of Your Charity*

Yes

Team Type*

Two Adults

Adult and Child Under 10

Two Children 8-10

Checkout Total

Payment Method*

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

By checking this box I confirm that:

Team ID

Website cookies

Register For The Isle Listen Three-Legged Race

Please note:

How your support helps our local community

Isle Listen

Register For The Isle Listen Three-Legged Race

Please note: