Bridges Walk 18th July 2010 Registration

Registration is £10 per adult. Children aged 16 and under, free - Please make cheques payable to 'CRY' and send to CRY, Unit 7, Epsom Downs Metro Centre, Waterfield, Tadworth, Surrey, KT20 5LR.

Alternatively, if you would like to pay by credit card we will provide a link on the next screen where you can pay on-line via PayPal.

Online registration closes 9th July 2010.

Registration

Contact Details Title
First Name
Last Name
Address
Address 2
Town/City
County
Postal Code
Daytime Phone Number
Mobile Phone Number
E-mail

Entry Details T-Shirt size
Team name (if applicable)
In memory of

Reason for taking part. If taking part in memory or support of someone, please indicate your relationship to that person and what name you would like on your personalised back sign?
Would you be prepared to help with the press/media?

If 'Yes', please download the media form on page two of this registration form.

If you are walking in memory of someone would you like your e-mail address added to a contact list which will be available to other walk participants.

If 'Yes', we will include the reason for taking part.

Additional Adults at £10 each Additional 1st adult name and Tshirt size
Additional 2nd adult name and Tshirt size
Additional 3rd adult name and Tshirt size
Total Number of adults to pay for

Accompanied Children (free of charge) Number of children aged 16 and under

T-Shirt requirements for children under 16 (5-6yrs, 7-9yrs, 9-11yrs or small adult)
Do you need details of the pram/wheelchair friendly route?

Terms and Conditions of entry

By ticking this box I agree with the following terms and conditions of entry

I understand that I am participating in the CRY Heart of London Bridges Walk at my own risk and that CRY (Cardiac Risk in the Young) will not accept liability for any injury or loss that may occur as a result of my taking part, other than as a result of CRY's negligence. I agree that medical advice should be sought from my GP if I am in any doubt as to my physical ability to take part. I also understand that I am responsible for the safety of any children accompanying me. I am aware that photographs taken at this event may be used to publicise future events and the work of CRY(Cardiac Risk in the Young)and/or organisations supporting this event.

Bridges Walk 18th July 2010 Registration

Copyright © 2009 Cardiac Risk in the Young. All rights reserved. Revised: 05/11

Copyright © 2009 Cardiac Risk in the Young. All rights reserved.
Revised: 05/11