Event registration - Hadrian's Wall 2022 Registering for our event We’re delighted to see that you would like to register for our Hadrian's Wall trek. 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* 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 - emailAbout 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: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 non-refundable registration fee and to raise a minimum level of sponsorship for the Hospice.Please give details of how you plan to fundraise for this event:Event RegistrationRegistation* 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 WhatsApp*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 I do not consent to be added to a WhatsApp group for the purpose 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 would like to contact from time to time with Hospice news, updates and information about other fundraising activities.*Please select how you would like to be contacted. Post Email Phone Text message I'd rather not be contacted by the Hospice 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.