Event registration - Challenge Event - 30th Anniversary Abseil Registering for our event We’re delighted to see that you would like to register for our event. To book your place please complete the booking form below or for further details contact our Fundraising Team on 020 8319 9230 or email at firstname.lastname@example.orgYour detailsFirst name* Surname* Address* Street Address Address Line 2 City County AvonBedfordshireBerkshireBuckinghamshireCambridgeshireCheshireClevelandCornwallCumbriaDerbyshireDevonDorsetDurhamEast SussexEssexGloucestershireHampshireHerefordshireHertfordshireIsle of WightKentLancashireLeicestershireLincolnshireLondonMerseysideMiddlesexNorfolkNorthamptonshireNorthumberlandNorth HumbersideNorth YorkshireNottinghamshireOxfordshireRutlandShropshireSomersetSouth HumbersideSouth YorkshireStaffordshireSuffolkSurreyTyne and WearWarwickshireWest MidlandsWest SussexWest YorkshireWiltshireWorcestershireClwydDyfedGwentGwyneddMid GlamorganPowysSouth GlamorganWest GlamorganAberdeenshireAngusArgyllAyrshireBanffshireBerwickshireButeCaithnessClackmannanshireDumfriesshireDunbartonshireEast LothianFifeInverness-shireKincardineshireKinross-shireKirkcudbrightshireLanarkshireMidlothianMorayNairnshireOrkneyPeeblesshirePerthshireRenfrewshireRoss-shireRoxburghshireSelkirkshireShetlandStirlingshireSutherlandWest LothianWigtownshireAntrimArmaghDownFermanaghLondonderryTyrone Postcode Email* Enter Email Confirm Email Phone*Date of birth*The minimum age for this challenge is 12. Any children between 12-17 taking part need to be accompanied by two adults on the experience who will abseil before and after them. Children must be accompanied at all times. DD slash MM slash YYYY How did you hear about the event?*Social mediaHospice websiteNewsletter/emailPosterPressThrough a friendOtherNext of kin detailsNext of kin - first name* Next of kin - surname* Next of kin - phone*Next of kin - email* About youDo you have a personal experience, story or reason why you have chosen to support the Hospice? If so, please share the details here:Do you have a reasonable level of fitness?Please summarise here:Do you have a medical condition or disability that may prevent you taking part in any of the activities or that we should be aware of?Please state any here:The minimum age to take part in this event is twelve. Any children between 12 and 17 must be accompanied by two adults, who will abseil before and after them. There is no upper age limit as long as you are fit and healthy. There is a weight limit of 21 stone and participants you must 1.2m in height. All participants will need to sign a waiver before taking part and adults will need to sign on behalf of minors.Please confirm below that you have read and understood the above statement. Do you work for a company that offers Match Funding?If so, please complete the following details: Name of employer: Your job title: FundraisingTo secure your place, we ask participants to pay a £30 non-refundable registration fee and to raise a minimum level of sponsorship of £135 for the Hospice.Please give details of how you plan to fundraise for this event:Event RegistrationProduct Name* Price: Total £ 0.00 Participating* I understand that I take part in this event at my own risk and that Greenwich & Bexley Community Hospice cannot be held responsible for any loss, damage, or injury, however caused as a result of the event. I agree that any images taken during the event may be used for publicity purposes We would like to add you to a Whatsapp group with other participants of this event. It is a quick and easy way for us to share information with the group - and for you to share photos etc afterwards. I agree to being added to a Whatsapp group and receiving information and fundraising support via whatsapp for the purposes of this event By registering for this event we will contact you by post and email about the event. We would also love to stay in touch to tell you about the amazing difference that you’ve made, update you with the work we are doing and other ways to support. We want you to be completely happy with how we communicate with you and you can change your mind at any time. Call 020 8319 9230 or email email@example.com We’d love to keep you updated about our work and how you are making a difference to the people we support. We would like to send you information about our fundraising and events, and other ways in which you can help us. We will write to you by post unless you ask us not to. Please tell us if there are other ways you’d like to hear from us.Please select how you would like to be contacted. Yes, I am happy to receive occasional phone calls Yes, I am happy to receive text messages Yes, I am happy to receive emails No, please don’t send me information by post I would like to make an additional donation to support the work of the Hospice Boost your donation by 25p of Gift Aid for every £1 you donateGift Aid is reclaimed by the charity from the tax you pay for the current tax year. Your address is needed to identify you as a current UK taxpayer.Gift aid I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want to Gift Aid this donation and any donations I make in the future or have made in the past 4 years to Greenwich & Bexley Community Hospice. I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference. I understand the charity will reclaim 25p of tax on every £1 that I have given. I will notify Greenwich & Bexley Community Hospice if my name, home address or tax-paying status changes.