Santa Dash Application Form

Please complete a separate form for each participant. Compulsory data is indicated by *

PARTICIPANT DETAILS
First Name*
Surname *
Gender * Male Female
Date of birth * (dd-mm-yyyy, e.g. 01-01-2000)
Address *
Town *
Postcode *
Telephone No. *
Mobile No.
Contact Email Address *
(Please use Parent/Guardian email if under 16)
EMERGENCY CONTACT DETAILS
Please provide details for 2 adults (must be over 18) who can be contacted in case of emergency.
Contact 1
Name *
Telephone No. *
Contact 2
Name *
Telephone No. *
MEDICAL INFORMATION
Please detail any medical conditions which we should be aware of prior to participating in this event.
Leisure & Culture Dundee will administer basic emergency first aid in accordance with the
relevant medical authorities. This however, will exclude administration of all medicines.
The following section must be completed if the participant is a child under the age of 16.
Please note that children under 12 must be accompanied by a participating adult on the day.
PARENT/GUARDIAN DETAILS
Title
First Name
Surname
Date of birth (dd-mm-yyyy, e.g. 01-01-1970)
Address
Town
Postcode
Telephone No.
Mobile No.
Contact Email Address
PHOTO CONSENT
Leisure & Culture Dundee will be taking photographs and videos on the day along with members
of the press for official use only by Leisure & Culture Dundee and our Partners. By participating in
this event, you consent to being filmed or photographed at this event. These images may be used
on our website, promotional material or social media for promotional purposes only.
PERMISSION TO ATTEND
Leisure & Culture Dundee asks participants to adhere to its Codes of Conduct to ensure the
health, safety and enjoyment of all participants. Failure to do so could result in the participant being
excluded from the event. Click here to see our Codes of Conduct which should be adhered to.

Your details will be retained on a database for use only by Leisure & Culture Dundee. These
details will not be passed to any other agency or third party. Click here to open and read Data
Protection Info.

I declare that the information given in this form is correct at time of writing.

I confirm that I have read and acknowledge the codes of conduct and data protection info. *
Please tick the box if you DO NOT wish to receive information on other programmes
and activities run by Leisure & Culture Dundee.
HOW DID YOU HEAR ABOUT THIS EVENT?
*