Events application form

Please use this form if you want to support Help the Hospices. If you would like to support a specific hospice, please search for a UK hospice to contact them directly.

Event selection

Event »

Adidas Silverstone Half Marathon (EV00486)
Bupa Great North Run (EV00501)
Bupa London 10,000 (EV00489)
Edinburgh Marathon (EV00491)
Grim challenge (EV00488)
HellRunner (EV00488)
London to Amsterdam Bike Ride (EV00490)
London to Brighton Bike Ride (EV00502)
London to Brighton Challenge (EV00521)
London Triathlon (EV00504)
New York City Marathon (EV00499)
Royal Parks Half Marathon (EV00503)
Scottish Half Marathon (EV00492)
Virgin London Marathon 2013 (EV00510)
Thames Path Challenge (EV00522)
Other Events (EV00488)

An event not listed above

Have you applied to the event ballot for your own place?

Yes
No

Have you already had your own place confirmed in this event?

Yes
No

Your details

First Name »

Last Name »

Email »

Address 1 »

Address 2

Town/City »

County

Postcode »

Daytime phone »

Evening phone/mobile

Gender »

Male
Female

Date of birth

Day

DD -- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Month

MM -- 01 02 03 04 05 06 07 08 09 10 11 12

Year

YYYY ---- 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922

Application details

Name of company/employer

Please give details of your previous running\fitness experience »

What is your fundraising target? (£) »

How do you plan to raise this? »

Have you got a particular connection with the hospice cause? »

How did you hear about Help the Hospices? » Select an Item -------------- Event magazine (eg Marathon News) Event website Help the Hospices website Internet search (eg google) National media Personal contact Previous event Realbuzz website Runners World Time outdoors Through a local hospice Trader Media Group publication Workplace Take it Easy Twitter Facebook

Vest Size » Select an Item -------------- Male S Male M Male L Male XL Male XXL Female 8 Female 10 Female 12 Female 14 Female 16

Would you be happy for us to contact you to discuss sharing your story for publicity purposes? »

Yes
No

If you have chosen to take part in an event on behalf of Help the Hospices, the information provided by completing this registration form will not be shared with any third parties. If you wish for Help the Hospices to contact you in future, please opt in below.

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Please inform me of upcoming events