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Registration Info:

Please enter information in the form below to process registration for event Kiltimagh Race 2 Glory - 2025.

Please Choose Your Race Option: *

Full Race - €49 per person

Sprint Race - €49 per person

Full Race Relay - Team of 3 (€99)

Please Enter Your Details

Team Member 1 Information

First Name * *

Last Name * *

Date of Birth; (dd/mm/yyyy) *

Gender *

Male

Female

T-Shirt Size: *

Small

Medium

Large

X-Large

Phone Number: *

**Email Address** *

Club / School / College

Emergency Contact Name: *

Emergency Phone Number: *

Team Member 2 Information

Relay Member 2 First Name *

Relay Member 2 last Name *

Date of Birth; (dd/mm/yyyy) *

Relay Member 2 Gender *

Male

Female

Relay Member 2 Tee Shirt Size *

Small

Medium

Large

X-Large

Relay Member 2 Phone Number *

Team Member 3 Information

Relay Member 3 First Name *

Relay Member 3 Last Name *

Date of Birth; (dd/mm/yyyy) *

Relay Member 3 Gender *

Male

Female

Relay Member 3 Tee Shirt Size *

Small

Medium

Large

X-Large

Relay Member 3 Phone Number *

Relay Acceptance *

I/We are entering the Kiltimagh Race 2 Glory Relay - On the FULL RACE ONLY

Email Address: *

Payment Information

Amount

€

Payment Processing Fee

€

Gross Amount

€

Payment Method

Securely Processed Debit / Credit Card Payment

Credit Card Number*

Expiration Date*

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Card (CVV) Code*

Card Holder Name*

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Registration Info:

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Team Member 1 Information

Team Member 1 Information

Team Member 2 Information

Team Member 2 Information

Team Member 3 Information

Team Member 3 Information

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