Sparkle 2021 registration form

  • Please get this from your order email, if it is not automatically filled.
  • Please fill in all the information about the event entrants on your team. Use the + symbol to add all of your team.
    Full NameAddressPhone NumberEmail AddressDOBName of Guardian if under 18*Consent for child to take partEmergency Contact Name*Emergency Contact Telephone numberT-Shirt SizePhoto Consent*Email Consent* 

*Guardian – If over 18 please enter N/A

*Emergency contact – should be someone not participating in the walk.

*Email – I am happy for St Andrew’s Hospice to contact me about their news, events and fundraising activities. You can update your preferences at any time by contacting louise.bullimore@nhs.net or 01472 571269

*Photo – I consent to St Andrew’s Hospice taking photographs/ videos of me at this event. These photos/ videos may be used on their website and on social media as well as in printed publications.

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