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18 KM Anti-Drug Awareness Run · 2026-08-29

1. Participant Details

Full name * Date of birth * Gender * Mobile number * Email (optional) CityDistrictState

Address *

Age and category will be calculated automatically from DOB.

2. Participant Health Declaration

Heart disease

No Yes

High blood pressure

No Yes

Diabetes

No Yes

Asthma / respiratory disease

No Yes

Kidney disease

No Yes

Seizure disorder

No Yes

Other significant medical condition

No Yes

Chest pain during exercise

No Yes

Fainted / collapsed during exercise

No Yes

Unusual or severe breathlessness during exercise

No Yes

Unexplained palpitations during exercise

No Yes

Current injury affecting running

No Yes

Currently taking regular medication

No Yes

Known drug / food allergy

No Yes

Medical condition detailsInjury detailsMedication detailsAllergy details Previous running experience

High-risk answers may result in MEDICAL REVIEW REQUIRED. This does not automatically reject registration.

3. Emergency Contact

Name *Relationship *Mobile *Alternative mobile

Address *

4. Parent / Guardian Details

NameRelationshipMobileAlternative mobile

Address I confirm that I am the parent/legal guardian and consent to participation.

5. Final Declaration

I declare that the information provided is true and complete to the best of my knowledge. I understand that participation in an 18 KM running event involves physical exertion and agree to follow organiser, safety and medical instructions.

I Agree *

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