Registration form

Please fill in all parts of this form.
Name Date of Birth Gender Address E-mail Confirm E-mail Mobile Phone
This program will run for 12 weeks, and places are highly saught after, can you commit to the whole program?
Yes
No
Are you available between 9-11am on Saturday April 11th 2026 for your 5K celebration run?
Yes
No
Are you interested in joining the main club after this program? (This is just so we can plan for the coming year)
Yes
No
Maybe, I'm not sure yet!
What is your main motivation to join?
Get fitter / healthier
Lose weight
To take up running for the first time
For my mental health
To meet new people / make friends
Can you currently walk for 20 min at any speed without stopping?
Have you ever ran before?
I have never ran before
I've not ran since school
I used to run a little
I run a little but I want to improve
I was a club runner but haven't ran in a long time
Please tell us of any medical conditions which may affect your time with us and confirm that you are safe to participate with any relevant medication.
We love to use Social Media to promote our club. Are you happy for us to use your photos and videos on our Social Media channels and local press? No one is singled out, its usualy group photos and videos - have a look at our Instagram to see examples.
Yes
No
Let us know your Social Media Handles I agree to the Terms & Conditions and Privacy Policy Submit

Jog Scotland Larkhall

Fill in the registration form to join us for our Couch to 5k group. 
We expect this to be oversubscribed and we will need to cap numbers for safety reasons. 
We recommend signing up without delay as once we reach the maximum number, sign up will be closed.  

Your place is not confirmed untill we send you a welcome email.