Thank you fortaking part in the Seafarers UK 100 Challenge.

PLEASE COMPLETE THE FOLLOWING STEPS:

  1. Read and complete all sections of this registration form
  2. Sign the declaration confirming your fundraising pledge and agreement to abide by the Terms and Conditions.
  3. Email a copy of the completed form or post a completed copy to Alex Ward, Seafarers UK, 8 Hatherley Street, London, SW1P 2QT.
    Please retain a copy for your reference.

PERSONAL DETAILS

Title
Forename(s)
Surname
Address
City / Town
County
Postcode
Telephone (day time)
Telephone (evening)
Telephone (mobile)
Email address
Twitter Handle – if you have one
Date of Birth (dd/mm/yy)
Organisation – if applicable
Job Title
Does your organisation run a matched giving scheme?

YOUR 100 CHALLENGE

What is your 100 Challenge?
How did you hear about the
100 Challenge?
By what date do you expect to have completed your
100 Challenge?
How do you intend raising £100? e.g Just Giving Page, sponsorship, collection at work
We will send you a Seafarers UK 100 Challenge t-shirt. Which size you would you like?
Small, Medium, Large or X Large
Do you have a personal connection to the maritime community that you would like to share with us?

DECLARATION

I have read, understood and agree to abide by the Terms and Conditions. I understand and agree toaim to raise a minimum of £100.00(excluding Gift Aid) for Seafarers UK by 31 December 2017.

Signature
Date

SEAFARERS UK TERMS AND CONDITIONS

  1. When fundraising, participants must agree to act lawfully and follow the fundraising guidelines given by Seafarers UK. We ask that fundraisers do not do anything that may harm Seafarers UK’s reputation or act in a manner contrary to our values.
  1. Participation in the 100 Challenge is at your own risk. Your challenge should be safe and not put yourself or anyone else in danger. Seafarers UK do not accept responsibility or liability for any loss or damage, or for any death or personal injury arising out of any fundraising activities or events which are not directly organised by us.
  2. If you wish to withdraw from the 100 Challenge for any reason, please notify Seafarers UK at the earliest opportunity. If this occurs any money raised will be retained as a donation towards Seafarers UK.
  3. By registering to take part in this event you are agreeing to share your 100 challenge photographs via social media and with Seafarers UK directly and give permission for Seafarers UK to use your photographs and any video content of you for publicity material used by Seafarers UK.
  1. Seafarers UK actively seeks publicity to promote and create awareness about its work. If there is anything about your 100 Challenge that might make a good story for the media then please contact Seafarers UK on 020 7932 5960.
  1. Seafarers UK comply with the Data Protection Act 1998 with regard to the handling of personal information.Our Privacy Policy may be viewed on our website

Thank you for taking part in the 100 Challenge and choosing to support

Seafarers UK.

Seafarers UKt 020 7932 0000
8 Hatherley Street f 020 7932 0095
London SW1P 2QT UK /
Seafarers UK (King George’s Fund for Sailors) is a registered charity.
Registered Charity Number 226446, in England and Wales, incorporated under
Royal Charter, and registered in Scotland under number SC038191