Event registration - Colour Run 2019 Thank you for supporting our Colour Run, we hope you have a great day on Sunday 30th June. All Colour Runners will be given a medal at the finish. Thank you again for supporting the hospice. To register your place, please complete the online registration form below or for further details contact the Fundraising Team on 020 8319 9230 or email fundraising@gbch.org.uk if you have any queries.Your DetailsFirst name*Surname* Date of birth* DD MM YYYY Address* Street Address Address Line 2 City County Avon Bedfordshire Berkshire Buckinghamshire Cambridgeshire Cheshire Cleveland Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire London Merseyside Middlesex Norfolk Northamptonshire Northumberland North Humberside North Yorkshire Nottinghamshire Oxfordshire Rutland Shropshire Somerset South Humberside South Yorkshire Staffordshire Suffolk Surrey Tyne and Wear Warwickshire West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Clwyd Dyfed Gwent Gwynedd Mid Glamorgan Powys South Glamorgan West Glamorgan Aberdeenshire Angus Argyll Ayrshire Banffshire Berwickshire Bute Caithness Clackmannanshire Dumfriesshire Dunbartonshire East Lothian Fife Inverness-shire Kincardineshire Kinross-shire Kirkcudbrightshire Lanarkshire Midlothian Moray Nairnshire Orkney Peeblesshire Perthshire Renfrewshire Ross-shire Roxburghshire Selkirkshire Shetland Stirlingshire Sutherland West Lothian Wigtownshire Antrim Armagh Down Fermanagh Londonderry Tyrone Postcode Phone*Email* Enter Email Confirm Email TicketsFamily Ticket(2 Adults & 2 children aged 5-15) Price: £ 45.00 QuantityPlease selectOne family ticketAdult Price: £ 15.00 QuantityPlease selectOne adult ticketTwo adult ticketsThree adult ticketsFour adult ticketsFive adult ticketsChild(aged 5 to 15 years inclusive) Price: £ 10.00 QuantityPlease selectOne child ticketTwo child ticketsThree child ticketsFour child ticketsFive child ticketsTotal £ 0.00 Colour Runner details Family Adult name* First Last Date of birth* DD MM YYYY 2nd Family Adult name* First Last Date of birth* DD MM YYYY Email if different from above Address if different from above Street Address Address Line 2 City County Avon Bedfordshire Berkshire Buckinghamshire Cambridgeshire Cheshire Cleveland Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire London Merseyside Middlesex Norfolk Northamptonshire Northumberland North Humberside North Yorkshire Nottinghamshire Oxfordshire Rutland Shropshire Somerset South Humberside South Yorkshire Staffordshire Suffolk Surrey Tyne and Wear Warwickshire West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Clwyd Dyfed Gwent Gwynedd Mid Glamorgan Powys South Glamorgan West Glamorgan Aberdeenshire Angus Argyll Ayrshire Banffshire Berwickshire Bute Caithness Clackmannanshire Dumfriesshire Dunbartonshire East Lothian Fife Inverness-shire Kincardineshire Kinross-shire Kirkcudbrightshire Lanarkshire Midlothian Moray Nairnshire Orkney Peeblesshire Perthshire Renfrewshire Ross-shire Roxburghshire Selkirkshire Shetland Stirlingshire Sutherland West Lothian Wigtownshire Antrim Armagh Down Fermanagh Londonderry Tyrone Postcode 1st Child's name* First Last Date of birth* DD MM YYYY Accompanying adult name* First Last 2nd child's name* First Last Date of birth* DD MM YYYY Accompanying adult name* First Last Adult name* First Last Date of birth* DD MM YYYY Email if different from above Address if different from above Street Address Address Line 2 City County Avon Bedfordshire Berkshire Buckinghamshire Cambridgeshire Cheshire Cleveland Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire London Merseyside Middlesex Norfolk Northamptonshire Northumberland North Humberside North Yorkshire Nottinghamshire Oxfordshire Rutland Shropshire Somerset South Humberside South Yorkshire Staffordshire Suffolk Surrey Tyne and Wear Warwickshire West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Clwyd Dyfed Gwent Gwynedd Mid Glamorgan Powys South Glamorgan West Glamorgan Aberdeenshire Angus Argyll Ayrshire Banffshire Berwickshire Bute Caithness Clackmannanshire Dumfriesshire Dunbartonshire East Lothian Fife Inverness-shire Kincardineshire Kinross-shire Kirkcudbrightshire Lanarkshire Midlothian Moray Nairnshire Orkney Peeblesshire Perthshire Renfrewshire Ross-shire Roxburghshire Selkirkshire Shetland Stirlingshire Sutherland West Lothian Wigtownshire Antrim Armagh Down Fermanagh Londonderry Tyrone Postcode Adult name* First Last Date of birth* DD MM YYYY Email if different from above Address if different from above Street Address Address Line 2 City County Avon Bedfordshire Berkshire Buckinghamshire Cambridgeshire Cheshire Cleveland Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire London Merseyside Middlesex Norfolk Northamptonshire Northumberland North Humberside North Yorkshire Nottinghamshire Oxfordshire Rutland Shropshire Somerset South Humberside South Yorkshire Staffordshire Suffolk Surrey Tyne and Wear Warwickshire West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Clwyd Dyfed Gwent Gwynedd Mid Glamorgan Powys South Glamorgan West Glamorgan Aberdeenshire Angus Argyll Ayrshire Banffshire Berwickshire Bute Caithness Clackmannanshire Dumfriesshire Dunbartonshire East Lothian Fife Inverness-shire Kincardineshire Kinross-shire Kirkcudbrightshire Lanarkshire Midlothian Moray Nairnshire Orkney Peeblesshire Perthshire Renfrewshire Ross-shire Roxburghshire Selkirkshire Shetland Stirlingshire Sutherland West Lothian Wigtownshire Antrim Armagh Down Fermanagh Londonderry Tyrone Postcode Adult name* First Last Date of birth* DD MM YYYY Email if different from above Address if different from above Street Address Address Line 2 City County Avon Bedfordshire Berkshire Buckinghamshire Cambridgeshire Cheshire Cleveland Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire London Merseyside Middlesex Norfolk Northamptonshire Northumberland North Humberside North Yorkshire Nottinghamshire Oxfordshire Rutland Shropshire Somerset South Humberside South Yorkshire Staffordshire Suffolk Surrey Tyne and Wear Warwickshire West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Clwyd Dyfed Gwent Gwynedd Mid Glamorgan Powys South Glamorgan West Glamorgan Aberdeenshire Angus Argyll Ayrshire Banffshire Berwickshire Bute Caithness Clackmannanshire Dumfriesshire Dunbartonshire East Lothian Fife Inverness-shire Kincardineshire Kinross-shire Kirkcudbrightshire Lanarkshire Midlothian Moray Nairnshire Orkney Peeblesshire Perthshire Renfrewshire Ross-shire Roxburghshire Selkirkshire Shetland Stirlingshire Sutherland West Lothian Wigtownshire Antrim Armagh Down Fermanagh Londonderry Tyrone Postcode Adult name* First Last Date of birth* DD MM YYYY Email if different from above Address if different from above Street Address Address Line 2 City County Avon Bedfordshire Berkshire Buckinghamshire Cambridgeshire Cheshire Cleveland Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire London Merseyside Middlesex Norfolk Northamptonshire Northumberland North Humberside North Yorkshire Nottinghamshire Oxfordshire Rutland Shropshire Somerset South Humberside South Yorkshire Staffordshire Suffolk Surrey Tyne and Wear Warwickshire West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Clwyd Dyfed Gwent Gwynedd Mid Glamorgan Powys South Glamorgan West Glamorgan Aberdeenshire Angus Argyll Ayrshire Banffshire Berwickshire Bute Caithness Clackmannanshire Dumfriesshire Dunbartonshire East Lothian Fife Inverness-shire Kincardineshire Kinross-shire Kirkcudbrightshire Lanarkshire Midlothian Moray Nairnshire Orkney Peeblesshire Perthshire Renfrewshire Ross-shire Roxburghshire Selkirkshire Shetland Stirlingshire Sutherland West Lothian Wigtownshire Antrim Armagh Down Fermanagh Londonderry Tyrone Postcode Adult name* First Last Date of birth* DD MM YYYY Email if different from above Address if different from above Street Address Address Line 2 City County Avon Bedfordshire Berkshire Buckinghamshire Cambridgeshire Cheshire Cleveland Cornwall Cumbria Derbyshire Devon Dorset Durham East Sussex Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire London Merseyside Middlesex Norfolk Northamptonshire Northumberland North Humberside North Yorkshire Nottinghamshire Oxfordshire Rutland Shropshire Somerset South Humberside South Yorkshire Staffordshire Suffolk Surrey Tyne and Wear Warwickshire West Midlands West Sussex West Yorkshire Wiltshire Worcestershire Clwyd Dyfed Gwent Gwynedd Mid Glamorgan Powys South Glamorgan West Glamorgan Aberdeenshire Angus Argyll Ayrshire Banffshire Berwickshire Bute Caithness Clackmannanshire Dumfriesshire Dunbartonshire East Lothian Fife Inverness-shire Kincardineshire Kinross-shire Kirkcudbrightshire Lanarkshire Midlothian Moray Nairnshire Orkney Peeblesshire Perthshire Renfrewshire Ross-shire Roxburghshire Selkirkshire Shetland Stirlingshire Sutherland West Lothian Wigtownshire Antrim Armagh Down Fermanagh Londonderry Tyrone Postcode Child's Name* First Last Child's date of birth* DD MM YYYY Name of accompanying adult* First Last Child's Name* First Last Child's date of birth* DD MM YYYY Name of accompanying adult* First Last 3rd Child's Name* First Last 3rd Child's date of birth* DD MM YYYY Name of accompanying adult* First Last 4th Child's Name* First Last 4th Child's date of birth* DD MM YYYY Name of accompanying adult* First Last 5th Child's Name* First Last 5th Child's date of birth* DD MM YYYY Name of accompanying adult* First Last Your supportYour registration fee helps to cover the cost of the event, so we encourage you to raise as much sponsorship as you can to support your local Hospice. My fundraising target is ...If you are not raising sponsorship, please consider making a donation to the Hospice.I will make a donation to the Hospice for the amount of £... Boost your donation by 25p of Gift Aid for every £1 you donateGift Aid is reclaimed by Greenwich & Bexley Community Hospice 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. Declaration* I/we understand that I/we take part in this event at my/our 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 Colour Run event. I/we agree that any images taken during the event may be used for publicity purposes 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 fundraising@gbch.org.uk Please select how you would like to be contacted by the Hospice Post Email Phone Text message OR - I'd rather not be contacted by the Hospice How did you hear about the Colour Run?*Please selectSocial mediaHospice websiteBannersLetter/emailPosterPressThrough a friendDo you have a special reason for supporting the Hospice? (I.e. in memory of someone)Total amount payable £ 0.00
