Paris Marathon 2018

CharityRunner Details

Thank you for deciding to support The Stroke Association at the 2018Paris Marathon.

Please complete and return this form as soon as possible to be considered for a charity place.

1. Personal Details

Name:

Address:

Postcode:

Telephone Numbers:

HomeWork Mobile

Email address:

We are committed to protecting the environment, therefore where possible all information will be available to download. Please select ‘Yes’ if you are happy to download or receive the event information by email, or ‘No’ if you would prefer items by post. Yes/No

Date of Birth:

Please note - the Paris Marathon is only open to runners born in 1998 or earlier (must be 20 years old at the time of the event in 2018).

Gender:Male/Female

Do you have any medical conditions that we should know about?

You will be required by the race organisers to produce a medical certificate on the day of the race, signed by your doctor saying you are fit to take part. Participants will not be able to take part without this.

Next of Kin Details:

Name Relationship Contact No

Would you prefer a t shirt or running vest?

What size do you require?SmallMediumLarge

Are you a member of a running club? Yes/No

If so, which club are you affiliated to?

What is your estimated running time for the Paris Marathon?

2.Fundraising

Participants applying for a charity place are asked to raise a minimum £1000 in sponsorship.

How much sponsorship money do you realistically believe you will be able to raisefor the Stroke Association?

How do you plan to reach this target?

Participants permit The Stroke Association to use any photographs taken during the races for any advertising or editorial purposes including on the World Wide Web.

Signed______Date______

  • The Stroke Association would like to keep you informed about the work we are helping to make possible. Please choose 'Yes' if you are happy for us to contact you. YES  NO 
  • We will sometimes allow other organisations whose aims are in sympathy with our own to contact our supporters. Are you happy for these organisations to contact you. YES  NO 
  • Are you happy for us to send you information about the Stroke Association's work by email? YES  NO 

Please complete this form, and return it

We will then be in touch to let you know if you have been successful in obtaining a charity place.

The Events Team NW

The Stroke Association

6th Floor St James House

Pendleton Way

Salford

M6 5FW

1

Registered charity No 211015