MIDNIGHT WALK 2018 REGISTRATION FORM

SATURDAY 8TH SEPTEMBER 2018

Event HQ: North Bridge Leisure Centre, Halifax, West Yorkshire HX3 6TE

Start Time: Midnight - Registration opens at 10.30 pm

Registration Fee

(Place are limited. Entries available on the night for a £6 supplement) Registration fee includes a t-shirt and medal. A sponsor form will be enclosed with the walkers pack you will receive once we have processed your registration form. There is no minimum amount of sponsorship needed but all monies raised will go towards caring for people with life limiting illnesses at Overgate Hospice.

Please tick if you are registering a team:
Please enter team name:
Please select the appropriate walk: 7 miles 13 Miles
How did you hear about this event?
Other if option chosen
Personal Information:
Title:
Name:
Address:
Postcode:
Date of birth:
Telephone:
E-mail address:

By providing your email address above you understand that we may email you regarding this and future hospice events and developments. In order for us to communicate with you by email your name and email address will be passed to an external email provider who will act on our behalf. No other details will be passed on and your information will not be used to contact you for any other purpose.

Twitter Account:
Gender: Female Male Unspecified
Next of Kin Name:
Next of Kin Number:
Additional Information:
Pre order your waterproof poncho today at only £2.00 YesNo
You can select your t-shirt on the day of the event or collect it from a stipulated collection evening. Further information will follow in your welcome e-mail.
Please tick if any of your party is bringing a dog (£5 per dog):
Please enter the number of dogs you and any other walkers are bringing:
Please enter the names of the dogs you and any other walkers are bringing:

Rules:

By entering participants agree to indemnify the organisers against liability for accidents, theft and/or damage to property and any third party claims.
Correct walking clothing must be worn at all times.
Personal accidents and third party insurance is not provided by the organisers. It is incumbent upon walkers to provide their own insurance at their discretion.
All walkers must abide by the Highway Code. Please be courteous to other walkers, cyclists, horse riders and other road users.
Marshals will be situated around the course and their instructions should be obeyed.
Walker should be equipped for inclement weather.
Any walker who retires from the walk must inform the organisers.
NOTE: In the unlikely event of severe weather, the event will be postponed and held at a later date.

By submitting your application you agree you are fit to participate and will rules set out above and will not hold Overgate Hospice or any of the organisation/liable for accident/injury or third party claim during or after this event.

I confirm any walker under the age of 18 will be accompanied by an adult and have parental/guardian permission to participate

We would like to keep you updated about how your support helps Overgate Hospice. We will only contact you about our key achievements, events and how we are making a difference to the lives of local people with life limiting illnesses. We appreciate that some people may choose not to hear from us again. If this is the case, please tick here Box to opt out of all marketing communications by post from Overgate Hospice in the future.

  • Click here to opt out of postal marketing communications

Sponsored by