Registration : Bear Grylls Survival Race
The Bear Grylls Survival Race Series is some of the toughest and most challenging obstacle races going – join us to take on the challenge in 2016!

Complete the below form to get signed up and contact holly.middleditch@londonyouth.org for more information

Which Race would you like to participate in?
Taking part as a team? Please give details of other team members - for a team of 4 a registration discount is available.
Your answer
Title
Your answer
First Name
Your answer
Last Name
Your answer
Email address
Your answer
Mobile Number
Your answer
Date of birth
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/
DD
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YYYY
Please tick this box to confirm that you will be 18 years or over on race day
Required
Gender
Do you use twitter? What is your twitter handle?
Your answer
Company Name / Employer
Your answer
Does your company have a matched giving scheme
Address
Please note that the postal address you give will be the location we send your fundraising pack to
Address 1
Your answer
Address 2
Your answer
Town or City
Your answer
County
Your answer
Postcode
Your answer
Emergency Contact Name
Your answer
Emergency Contact Telephone Number
Your answer
Race Information
Is this your first challenge event?
Required
What is your estimated finish time?
Hrs
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Min
:
Sec
Do you require a London Youth T-Shirt / Cycling Jersey
Size required
What name would you like printed on your t-shirt
Your answer
Fundraising
We are thrilled that you want to run to support London Youth but please tell us a little bit more about why you have chosen to run for us this year?
Your answer
We ask all of our runners to raise £150 for the 5K and 10K races and £300 for the 30K race to help support our work with young people across the capital - how do you plan to raise this money?
Don't worry London Youth will be able to give you lots of tips and support with your fundraising!
Your answer
Your commitment
By signing up to take part in this challenge on behalf of London Youth you are committing to joining our team in raising much needed funds to support our work and to be an ambassador for London Youth on race day to represent and promote the charity.
Required
Media Consent
Please note that photos may be taken at this event. By submitting this form, you consent to the use of your image for future promotional and communication uses (in print and online) by London Youth.
Required
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