Run for Charity Events 2015 – Registration form

Action for Children has teamed up with Run for Charity to offer you places in some of the most sort after event across the UK.

For your chance to run in one of these events for Action for Children, please complete the form below. Once we have received your completed registration form and entry fee, we will send you a fundraising guide with everything you need to help raise sponsorship money to take part in your exciting event.

Name
Address
Post Code
Telephone
Email
Date of Birth

Please tick the box of the event you are registering for:

Event / Date / Distance / Entry Fee / Sponsorship / Tick
Vitality North London Half Marathon / 15.03.2015 / Allianz Park / £25 / £250
Yeovil Half Marathon / 29.03.2015 / Huish Park / £25 / £250
EverydayHero Milton Keynes Half Marathon / 04.05.2015 / Stadium MK / £25 / £250
EverydayHero Milton Keynes Marathon / 04.05.2015 / Stadium MK / £40 / £500
Vitality Run Hackney Half Marathon / 10.05.2015 / Hackney Marsh / £25 / £250
Mudnificent 7 / 01.08.2015 / Hart Park, Warwickshire / £25 / £250
Run to the Beat / 13.09.2015 / Wembley Park / £25 / £250
Northampton Half Marathon / 06.09.2015 / Northampton / £25 / £250
Sailsbury Half Marathon / 18.10.2015 / Salisbury Fire Station / £25 / £250

I enclose my registration fee of £25/£40 (please make cheques payable to ACTION FOR CHILDREN or alternatively leave your contact number below for card payment over the phone).

Please call me to take payment from my debit card

Contact Number: ______

I agree to raise the minimum sponsorship to take part in this event

Half Marathon - £250 Full Marathon - £500

I agree to take part in this event at my own risk and understand that Action for Children will not be responsible for any loss, damage to persons or equipment, injury or death resulting from this event.

I acknowledge that the Reebok Spartan Races are a sponsored event and I pledge to raise the minimum sponsorship for Action for Children.

Signed:
Date:

Please tick if you would be interested in:

·  Receiving information about Action for Children

by email by telephone by mail by SMS

·  Receiving information about Action for Children’s fundraising activities

by email by telephone by mail by SMS

From time to time we share data with carefully selected third parties who share our charitable aims. Please tick here if you would like us to share you data in this way

Please note: Your name and email address will be passed onto Run for Charity (the organisers of the Spartan Race) to allow them complete your registration process.

Return registration form:

Via email:

Via post: Laura Hanratta, ACTION FOR CHILDREN, Community Partnerships Fundraising Team,

3 The Boulevard, Ascot Road, Watford, WD18 8AG

Registered charity no. 1097940 / company no. 4764232 A charity registered in Scotland no. SC038092