Dorset Walk 2019 Registration
Complete this form to register for The Malcolm Whales Foundation Dorset Walk 2019.
Email address *
First Name *
Your answer
Last Name *
Your answer
Next Of Kin: *
Please enter the following information of your next of kin: Name, Relation, Email Address & Phone Number
Your answer
Age *
Your answer
Email *
Your answer
Phone *
Your answer
Travel Arrangements *
Please select whether you require a space on one of our mini-buses providedor whether you intend to make your own arrangements.
Medical Information *
Please state below whether you suffer from any allergies.
Your answer
Special Dietary Requirements *
Please state if you have any special dietary requirements.
Your answer
Tents *
Please select whether you plan to bring/share a tent or if you require one. The Malcolm Whales Foundation strongly advises that you bring your own tent or share with someone, as there are only a very limited number of tents available.
T-Shirt Size *
Required
Photo Permission *
Please select whether you are happy to grant permission for The Malcolm Whales Foundation to use any pictures involving yourself for social media and publicity purposes.
Required
Parent/Guardian Permission - Under 18's Only
If you are under the age of 18, you will need permission from your parent/guardian in order to participate on the Dorset Walk.Please tick the box below.
Connection To The Charity
Payment - Important Information
Thank you for completing the registration process. Once you click 'Submit', your place will be reserved.

In order to confirm your place on the Dorset Walk, you will need to make a payment to The Malcolm Whales Foundation.

Please send £85.00 (or the early bird offer of £75.00 if you sign up before the end of December) to the bank details below following your sign up:
Sort Code: 23-05-80
Account Number: 29796866
Reference: Name - Dorset19 (Example: JoeBloggs - Dorset 19)

If you require a minibus, there will be a £15.00 surcharge on the day.

Sponsorship
The Malcolm Whales Foundation wishes for each participant to raise a minimum of £100.00 for the event.

To get our sponsorship forms, information packs and most importantly, to see the fantastic causes we support, visit www.malcolmwhales.co.uk.

Thank you for your support.

A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms