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Federation of Inline Speed Skating
HOME
MEMBERSHIP
EVENTS
Race Calendar – all events
FISS Events
Club Level Events
RACE RESULTS
FIND A CLUB
BRITISH RECORDS
Record Claiming
Records Broken 2016
Records Broken 2017
Records Holding page
AGE CATEGORIES
GOVERNANCE
SAFEGUARDING
Policies
Code of Ethics & Conduct
DOCUMENTS
Federation of Inline Speed Skating Rulebook
Safeguarding and Child Protection – Best Practice for Clubs
Medical consent, Parental concent and Accident forms
Record claiming
NEWS
EVESHAM 30K ROAD RACE 2024: FISS ROAD RACE SERIES ROUND 2 REGISTRATION
EVESHAM 30K 2024: FISS ROAD RACE SERIES ROUND 2 REGISTRATION
PERSONAL DETAILS
Skater Name
(Required)
Please specify the skaters first name and surname
Birth Sex
(Required)
Please specify your birth sex
Male
Female
Gender Identity
If you would like your gender or gender pronouns to be referred to differently than your birth sex specified above, please provide details here
Membership
(Required)
I am a fully registered Member of the Federation of Inline Speed Skating
I am not a Member of the Federation
Club
(Required)
Please select your Club. If this does not apply to you, please select “independent”. If you are a Member of an International Club, please select “Other” and use the below text box to enter your Club.
Please select from the list
Birmingham Wheels Roller Speed Club (BWRSC)
East Midlands Racing (EMR)
Essex Skating Club (ESC)
Herts Roller Speed Club (HRST)
LondonSkaters Speed Team (LSST)
Midlands Roller Speed Club (MRSC)
North London Roller Speed Skating Club (NLR)
Wisbech Inline Speed Skating Club (WISS)
Independent (IND)
Other (International Club)
Please enter the name of your Club
Race Number
(Required)
Please enter your race number. If you do not have one, please enter “0” and one will be assigned to you.
DATE OF BIRTH
Day
(Required)
Please enter a number from
01
to
31
.
Month
(Required)
Please enter a number from
01
to
12
.
Year
(Required)
Please enter a number from
1900
to
2018
.
Hidden
CurrentYear
Hidden
Age
Please select whether you wish to enter as a senior or Master
(Required)
Seniors are 19 years and over. Masters are 30 years. A skater who is over the age of 30 can still register as a senior if they wish to be recognised and skate as a Senior rather than Master.
I wish to skate in the Senior category
I wish to skate in the Master category
CONTACT DETAILS
Name of parent/guardian
(Required)
Email
(Required)
Please enter a valid email address
Phone
(Required)
Please enter a valid contact number
Address
(Required)
Street Address
Address Line 2
City
County / State / Region
Post code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
RACE ENTRY
FISS Member Race Entry – Mini
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. Please only select “100m ONLY” if you intend to enter just the 100m.
Mini 3k (all races) – £10
Mini 100m ONLY – £5
Open/Non Member Race Entry – Mini
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. Please only select “100m ONLY” if you intend to enter just the 100m.
Mini 3k (all races) – £20
Mini 100m ONLY – £5
FISS Member Race Entry – Pupil
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. Please only select “100m ONLY” if you intend to enter just the 100m.
Pupil 5k (all races) – £10
Pupil 100m ONLY – £5
Open/Non Member Race Entry – Pupil
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. Please only select “100m ONLY” if you intend to enter just the 100m.
Pupil 5k (all races) – £20
Pupil 100m ONLY – £5
FISS Member Race Entry – Cadet
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Cadet 10k (all races) – £10
Cadet 100m ONLY – £5
Open/Non Member Race Entry – Cadet
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Cadet 10k (all races) – £20
Cadet 100m ONLY – £5
FISS Member Race Entry – Youth
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Youth 10k (all races) – £10
Youth Half Marathon (all races) – £10
MEDAL DISTANCE Youth 30k (all races) – £10
Youth 100m ONLY – £5
Open/Non member Race Entry – Youth
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Youth 10k (all races) – £20
Youth Half Marathon (all races) – £20
MEDAL DISTANCE Youth 30K (all race) – £20
Youth 100m ONLY – £5
FISS Member Race Entry – Junior
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Junior 10k (all races) – £20
Junior 21k – Half Marathon – (all races) – £20
MEDAL DISTANCE Junior 30K (all races) – £20
Junior 100m ONLY – £5
Open/Non Member Race Entry – Junior
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Junior 10k (all races) – £20
Junior Half Marathon (all races) – £30
MEDAL DISTANCE Junior 30K (all races) – £30
Junior 100m ONLY – £5
FISS Member Race Entry – Senior
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Senior 10k (all races) – £20
Senior Half Marathon (all races)- £20
MEDAL DISTANCE Senior 30K (all races) – £20
Senior 100m ONLY – £5
FISS Member Race Entry – Senior
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Senior 10k (all races) – £20
Senior Half Marathon (all races) – £20
MEDAL DISTANCE Senior 30K (all races) – £20
Senior 100m ONLY – £5
Open/Non Member Race Entry – Senior
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Senior 10k (all races) – £20
Senior Half Marathon (all races)- £30
MEDAL DISTANCE Senior 30K (all races) – £30
Senior 100m ONLY – £5
Open/Non Member Race Entry – Senior
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Senior 10k (all races) – £20
Senior Half Marathon (all races)- £30
MEDAL DISTANCE Senior 30K (all races) – £30
Senior 100m ONLY – £5
FISS Member Race Entry – Master
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Master 10k (all races) – £20
Master Half Marathon (all races) – £20
MEDAL DISTANCE Master 30K (all races) – £20
Master 100m ONLY – £5
Open/Non Member Race Entry – Master
(Required)
Please select your entry type. Adult skaters have several distance options – please ensure you select the correct distance. MEDAL DISTANCE = the distance where gold, silver or bronze can be achieved. Please only select “100m ONLY” if you intend to enter just the 100m.
Master 10k (all races)- £20
Master Half Marathon (all races) – £30
MEDAL DISTANCE Master 30K (all races) – £30
Master 100m ONLY – £5
Please use this section to OPT OUT of any supporting races
Please indicate if you DO NOT wish to participate in any of the supporting races
100m
1 Lap Time Trial
ADDITIONAL INFORMATION
Medical Informtion
Please provide details of any allergies, medical conditions or disabilities/impairments here and any additional support which may be required. Please include any prescription medication if applicable
Media consent
(Required)
Please indicate whether you consent to photographs or videos to be taken and/or published of you or your child. Such images/video will be used only in the appropriate manner by the federation/club and/or its approved photographers. If there is a Court or Child Protection Order in place, please email secretaryfiss@inlinespeed.co.uk with details
Yes – I give permission for images and/or videos of me/my child to be taken and/or published
No – I do not wish images and/or videos of me/my child to be taken and/or published
DATA CONSENT NOTICE
By submitting this form, you agree to the use of your data by the Club and Federation for the purposes of processing your registration and for the activities and records of the Federation of Inline Speed Skating and the Club, and for administering the event. You agree to bide by the Federation’s rules, regulations and policies. Your data will be used and processed in accordance with Data protection and GDPR legislation. It will not be provided to third parties and remains confidential.
PAYMENT
Total
Payment Method
(Required)
PayPal Checkout
Credit Card
American Express
MasterCard
Visa
Supported Credit Cards: American Express, MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
Payment for entry to Evesham 30K Road Race 2024
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