Registration and Donation Form

Name *

First

Last

Gender *

Female
Male

Nationality *

ID Card *

Date of Birth *

Age *

Email *

Phone *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

*For State/Province/Region re-enter your locality

Club

Expected finish race time (for those participating in races only)

Emergency Contact Name *

Emergency Contact Number *

Name and Surname of Payee *

Race/Walk Category and donation amount *

Additional Donation (Optional)

Total

0,00 €

Payment Method *

Card Number

Expiration Date

Security Code

Card Holder Name

Upon settlement of transaction, you will receive an e-mail from Caritas PayPal confirming receipt of your registration and donation.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

I, individually and/or parent, and/or guardian of a named minor, for and in consideration of the acceptance of this entity in the aforementioned event, do hereby release, remise, waive, and forever discharge Fondazzjoni Caritas Malta, St Patrick's Athletic Club Malta and any other supporting groups of this said event, together with all their officials, agents, officers, employees and volunteers, from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of, or relating to any injury, illness, loss, or damage, including death, relating to participation in the aforesaid events. I further state that I am in proper physical condition to participate in this event. I further grant permission to this race and organization conducting the race and/or agents authorized by them to use any photographs, videos, footage, and any other record of this event for any purpose. All entry fees are non-refundable and this entry is not transferable without the permission of Fondazzjoni Caritas Malta and St Patrick's Athletic Club. Data Privacy: Upon registering for this event, you will receive non-promotional emails related to this event such as update and other information specific to your participation.

Fondazzjoni Caritas Malta and St Patrick's Athletics Club would like to send you emails with information about other races, events, products, and promotions (you can unsubscribe at any time). Would you like to join the mailing list?

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