HHUGS Zip Wire Challenge
First Name *
Your answer
Surname *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
City *
Your answer
Postcode *
Your answer
Phone Number *
Your answer
E-Mail Address *
Your answer
Emergency Contact First Name *
Your answer
Emergency Contact Number *
Your answer
Do you have any medical conditions or accessibility needs that could affect or impair your ability to take part? (This will be provided to the centre prior) *
Your answer
If you have any food allergies or dietary requirements please state here: *
Your answer
How much you aiming to raise? *
Pay £30 Reg fee and add £50 to Fundraising target? *
I would like to join the Transport from? *
I would like HHUGS to make a JustGiving page for me? *
Please tick if you would NOT like to be added to a WhatsApp group with other participants to help you fundraise
What is your preferred method of contact? *
How did you hear about the challenge?
Your answer
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