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Extra Date for Britain V Cancer Due to the phenomenal response to the first Britain V Cancer Jordan Desert Trek – we are delighted to announce a second challenge date in November 2013. We have an amazing 120  More...

REGISTRATION FORM FOR " SNOWDONIA CHARITY CHALLENGE "

REGISTRATION FEE: £195

All field marked with are mandatory.
Team Name:
Event Name:
Captain Title:
Captain forename:
Captain surname:
Captain Date of birth: eg DD/MM/YYYY
Captain Address1:
Captain Address2:
Captain Town:
Captain County:
Captain Postcode:
Captain email address: Please take care of spaces while adding email address
Captain Main contact telephone:
Captain Home tel:
Captain Work tel:
Captain Mobile No:
Captain Job Title:
Captain Employers name:
Captain Employers address:
T-Shirt Size S / M / L / XL / XXL:
How did you hear about this event:
 
Team member2 Title:
Team member2 forename:
Team member2 surname:
Team member2 Date of birth: eg DD/MM/YYYY
Team member2 Address1:
Team member2 Address2:
Team member2 Town:
Team member2 County:
Team member2 Postcode:
Team member2 email address: Please take care of spaces while adding email address
Team member2 Home tel:
Team member2 Work tel:
Team member2 Mobile No:
Team member2 Job Title:
Team member2 Employers name:
Team member2 Employers address:
T-Shirt Size S / M / L / XL / XXL:
 
Team member3 Title:
Team member3 forename:
Team member3 surname:
Team member3 Date of birth: eg DD/MM/YYYY
Team member3 Address1:
Team member3 Address2:
Team member3 Town:
Team member3 County:
Team member3 Postcode:
Team member3 email address: Please take care of spaces while adding email address
Team member3 Home tel:
Team member3 Work tel:
Team member3 Mobile No:
Team member3 Job Title:
Team member3 Employers name:
Team member3 Employers address:
T-Shirt Size S / M / L / XL / XXL:
 
Team member4 Title:
Team member4 forename:
Team member4 surname:
Team member4 Date of birth: eg DD/MM/YYYY
Team member4 Address1:
Team member4 Address2:
Team member4 Town:
Team member4 County:
Team member4 Postcode:
Team member4 email address: Please take care of spaces while adding email address
Team member4 Home tel:
Team member4 Work tel:
Team member4 Mobile No:
Team member4 Job Title:
Team member4 Employers name:
Team member4 Employers address:
T-Shirt Size S / M / L / XL / XXL:
NAME OF TEAM’S NOMINATED NAVIGATOR

PLEASE NOTE: Every team taking part in the challenge must have at least one team member who can navigate on a mountain using a map and compass. Please give the name of one person in your team who can do this or who will undertake basic instruction on how to do this prior to the event
Have you or any of your team members taken part in an
Action for Charity challenge before?

If yes, please give details:

Approximate time team anticipates completing the challenge in (in hours)

Action for Charity promises to respect your privacy. The information
you have provided will be used by Action for Charity and the charity
concerned for the purposes of administering the event. The data we
gather and hold is managed in accordance with the Data Protection
Act (1998) and will not be passed on to other organisations. We will
not disclose or share personal information supplied by you with any
third party without your consent.Action for Charity would however
like to contact you about future charity events.Please tick the box
below if you do not wish us to do that.

I do not wish my details to be passed to other event participants


We do not wish to be contacted about future Action for Charity events

We would like to apply for a team place and
agree to abide by the Terms & Conditions.

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