Eden Valley Hospice
- 2010 Carlisle Midnight Walk Registration
Use this form to register for this event.
*Title
*First
Name
*Surname
Company
Name
(if applicable)
*House Name
or Number
*Street
*Town
County
*Postcode
Daytime
Telephone No:*
(This can be a mobile number)
Please provide a DAY TIME
phone number so that we can contact you if there is a problem
Evening or
Mobile Phone No (if different from above):
Email:
Team
Name (if applicable)
If you are taking part as a member of a group of walkers please
give your group a name and then we can link all your group
together.
How many in your team?
Please note, each member of
your team must complete a separate registration form in order to
sign/confirm agreement with the terms and conditions and in
order for us to issue a walk number.
Your Tee-Shirt Size
(Select your size)
Small
(10-12)
Medium
(14 -16)
Large
(16-18)
Xlarge
(18+)
Have you supported us in the past?
Yes
No
If Yes, what
did you do?
Declaration
please read condition of entry shown
on the right.
I
have read the conditions of entry for this event and by ticking
below agree to abide by these.
*please tick this to confirm you have
agreed to these terms and conditions.
Please advise us of
any medical conditions we should be aware of:
If you have
any comments or queries about the challenge or your registration
please enter these here.
To help our marketing of events please answer the
following questions.
How did you
hear about the challenge?
* If local
paper or Radio which one?
Once you click the button below
you will be taken to the payment section to pay your £10
registration fee by credit/debit card, if you do not make the
payment we will be unable to process your registration.
THE
MIDNIGHT
MEMORY WALK
Once you complete this form you will be taken
to the payment section so that you can pay your £10
registration.
Please make sure you provide a daytime contact number so that
we can call you if we have any problems.
IMPORTANT
Shown below are the Conditions of entry
applicable to this event.
The walk is open to females only
who must be at least aged 14 years or over on 25 June 2010
Walkers aged between 14 and 16 years of age
must be accompanied by a parent or guardian for the entire walk.
The aim of the walk is to give supporters the
opportunity to raise funds for Eden
Valley Hospice. Places will be allocated on a first come, first
served basis.
If you register, and then find that you are unable to take part,
please let us know as soon as you can as we may allocate your
place to another walker. However, you may not pass your place on
to another walker. No refund of registration fees are available.
Any unused sponsor forms must be returned to Eden Valley
Hospice. You must follow the instructions of Walk officials at
all times. A Registration Form must be completed for every
Walker, and the entry fee must accompany each form. No entries
will be accepted without the entry fee. The entry fee is a
non-refundable donation to Eden Valley Hospice which covers the
administration costs of the Walk.
You are asked to try and raise as much sponsorship as
possible for the work of Eden Valley Hospice.
