Please spell your name as you would like it to appear on any communication, badges etc.
This will be used to send you joining information about the event
This is used to order your running vest style
Please let us know who to contact in the event of an emergency.
Please provide a phone number we can use in case of an emergency at the event. Next of kin ideally. Please enter WITHOUT spaces.
Please check the box if you are happy to aim to raise a minimum fundraising target of £250
Please confirm that you will be over 18 years old on 17th October 2021. You should not enter and participate in the Event unless you are medically able and properly trained and it is your responsibility to monitor your own physical condition throughout the Event.
Cruse Bereavement Care
Unit 0.1, One Victoria Villas,
Surrey TW9 2GW
T:020 8939 9544 or 020 8939 9549