Event Day registration

HLBW Event Day Registration

Adult Participant

Registration Fee: £15.00

Number registering

Number of Children aged 16 and under?

Are you walking in memory of someone?

Please could you provide the name of the person you are walking in memory of?

Team Name?

Adult One - Title

Adult One - First Name

Adult One - Surname

Adult One - Relation to who they are walking in memory of?

T-shirt Size

Adult Two - First Name

Adult Two - Surname

T-shirt Size Adult Two

Adult Two - Relation to who they are walking in memory of?

Adult Three - First Name

Adult Three - Surname

T-shirt Size Adult Three

Adult Three - Relation to who they are walking in memory of?

Adult Four - First Name

Adult Four - Surname

T-shirt Size Adult Four

Adult Four - Relation to who they are walking in memory of?

Adult Five - First Name

Adult Five - Surname

T-shirt Size Adult Five

Adult Five - Relation to who they are walking in memory of?

Child One - First Name

Child One - Surname

Child One - T-shirt Size

Child One - Relation to who they are walking in memory of?

Child Two - First Name

Child Two - Surname

Child Two - T-shirt Size

Child Two - Relation to who they are walking in memory of?

Child Three - First Name

Child Three - Surname

Child Three - T-shirt Size

Child Three - Relation to who they are walking in memory of?

Child Four - First Name

Child Four - Surname

Child Four - T-shirt Size

Child Four - Relation to who they are walking in memory of?

Child Five - First Name

Child Five - Surname

Child Five - T-shirt Size

Child Five - Relation to who they are walking in memory of?

What is your reason for taking part?

No payment items has been selected yet

Pay with Card (Stripe)

Preventing young sudden cardiac deaths through awareness, screening and research, and supporting affected families.

01737 363222

cry@c-r-y.org.uk