Leicestershire 3 Peaks Challenge Registration & Disclaimer Form

    To be completed by all challengers (To be completed on behalf of children & young people by parent/carer)






    Email is the most efficient and cost-effective way for us to send out updates & information to you on the run-up to the challenge. We would also like to send you our monthly e-newsletter where information on the event and how the funds raised will make a difference will be included. Please tick here if you do not wish to receive this. You can unsubscribe at anytime.

    If completing form on behalf of a child (under 18), please give your details


    Entry type purchased

    Part of team entry?


    *This information allows us to add you to the relevant team.

    Part of family entry?

    *This information allows us to add you to the relevant family.

    Emergency Contact Details

    In case of illness/emergency on the day please provide us with emergency contact details.




    Medical Conditions

    Give details of all medical conditions, including allergies, current conditions (such as diabetes, asthma or epilepsy), and any conditions of the heart or current injuries that you may have. This information will be kept by our support team and accessed on the day if required.

    Estimated Completion Time

    This is a useful guide for us, especially for anyone planning to run the event (the route is approx. 16 miles and we expect everyone to complete within 8 hours).

    Parking Information

    To help with logistics on the day and liaison with park rangers, please tick yes if you intend to park at Beacon Hill for the duration of the Challenge so that we can estimate car numbers (driver only please, passengers tick no).

    Do you plan to bring a four-legged friend with you?

    How did you hear about this event?



    Event Disclaimer

    Please ensure you have read and signed / dated this form. Challengers will not be able to take part without the completion of this form. By signing the form you accept full responsibility for any injury, accident etc. which may result from participation in the event. Thank you

    “I confirm that I am familiar with the nature of the activity that I wish to undertake and acknowledge all the risks involved. I hereby declare that I am in good health, and that I am not suffering from any medical condition or disability that might make it unsafe for me to take part in the event. I accept that I shall be solely responsible for any decision as to my fitness to participate and to complete the challenge.

    I understand that I am taking part in an event which will require me to undertake exercise for a prolonged period. I will have, if necessary, gained advice from my GP as to whether I am physically prepared to undertake the challenge. I also understand that I will only undertake the challenge if I feel that I am physically able to do so.

    I confirm I have read the health and safety sheet. I understand that I am required to adhere to all safety guidelines provided by the event organisers prior to and on Challenge day. Failure to comply may result in removal from the event.

    Image release: I understand that by attending I am granting permission to the use of photographs, videos and other media captured during the event for promotional purposes. If I have any concerns, I will speak to the event organisers prior to the event.

    If there are any changes to the above prior to the challenge I will make the event organisers aware”.

    I, having read the terms and conditions of this application, on submitting this form provide approval and undertake acceptance of the above.

    Fundraising Information

    I, having read the event information pack, agree to the fundraising targets found in the pack.

    Parents/Guardians of participants under the age of 18

    I, having read the terms and conditions of this application, on submitting this form provide approval and undertake acceptance of the above.

    Once we have your entry fee and completed registration and disclaimer form we will confirm your place and will then keep in touch with all the information you need on the run up to the Challenge. Registration fees are non-refundable.

    If any of the above details change in between completing the form and the challenge itself, please notify us. All information provided will be used only for the purpose of this challenge and will be destroyed after the event. Challengers will not be able to participate in the event unless we have a completed form.

    If you have any questions please email hello@charity-link.org or call 0116 222 2200.

    We look forward to welcoming you to the Challenge!