Run for Charity Events 2015 – Registration formAction for Children has teamed up with Run for Charity to offer you places in some of the most sort after event across the UK.

For your chance to run in one of these events for Action for Children, please complete the form below. Once we have received your completed registration form and entry fee, we will send you a fundraising guide with everything you need to help raise sponsorship money to take part in your exciting event.

Name

Address

Post Code

Telephone

Email

Date of Birth

Please tick the box of the event you are registering for:

Event Date Distance Entry Fee

Sponsorship

Tick

Vitality North London Half Marathon

15.03.2015 Allianz Park £25 £250

Yeovil Half Marathon 29.03.2015 Huish Park £25 £250

EverydayHero Milton Keynes Half Marathon

04.05.2015 Stadium MK £25 £250

EverydayHero Milton Keynes Marathon

04.05.2015 Stadium MK £40 £500

Vitality Run Hackney Half Marathon

10.05.2015 Hackney Marsh £25 £250

Mudnificent 7 01.08.2015 Hart Park, Warwickshire

£25 £250

Run to the Beat 13.09.2015 Wembley Park £25 £250

Northampton Half Marathon 06.09.2015 Northampton £25 £250

Sailsbury Half Marathon 18.10.2015 Salisbury Fire £25 £250

Station

I enclose my registration fee of £25/£40 (please make cheques payable to ACTION FOR CHILDREN or alternatively leave your contact number below for card payment over the phone).

Please call me to take payment from my debit cardContact Number: ______________________________

I agree to raise the minimum sponsorship to take part in this event

Half Marathon - £250 Full Marathon - £500

I agree to take part in this event at my own risk and understand that Action for Children will not be responsible for any loss, damage to persons or equipment, injury or death resulting from this event.

I acknowledge that the Reebok Spartan Races are a sponsored event and I pledge to raise the minimum sponsorship for Action for Children.

Signed:

Date:

Please tick if you would be interested in:

Receiving information about Action for Children by email by telephone by mail by SMS

Receiving information about Action for Children’s fundraising activitiesby email by telephone by mail by SMS

From time to time we share data with carefully selected third parties who share our charitable aims. Please tick here if you would like us to share you data in this way

Please note: Your name and email address will be passed onto Run for Charity (the organisers of the Spartan Race) to allow them complete your registration process.

Return registration form:

Via email: Challenge@actionforchildren.org.ukVia post: Laura Hanratta, ACTION FOR CHILDREN, Community Partnerships Fundraising Team,

3 The Boulevard, Ascot Road, Watford, WD18 8AGRegistered charity no. 1097940 / company no. 4764232 A charity registered in Scotland no. SC038092