Reserve your place

Personal Details (as on your passport)

Challenge

Departure Date

Title

Forename

Surname

Preferred name

Address

Postcode

Daytime Telephone

Evening Telephone

We would like to keep you up to date with details of news events on international challenges. Please complete your email address below if you are happy for us to do so:

Email Address

Occupation

Company Name

NB: Your passport must be valid until 6 months after the date of return to the U.K.

Special Dietary Requirements

Are you a vegetarian?

Yes No

Do you have any dietary requirements?

Yes No

If yes give details:

Friends / Room Sharing

Accommodation will be shared. If you would like to share a room with your friend(s) please give details below (we will make every effort possible, but cannot guarantee that you will share as requested):

Names

Charity You Would Like To Support

Names, address & registration number of charity:

Reasons why you have chosen this Charity:

Previous Participation

Have you taken part in a similar event before?

Yes No

If yes, where, when and for which charity?

Where Did You Hear About Challenge For Charity

Please give details:

How To Apply

1. Please complete your registration form on this page.

2. We will send you the following within 5 working days:

- Medical Questionnaire
- Terms & Conditions
- Details of how to pay your registration fee

3. Simply post back the completed Medical Questionnaire and Payment details

4. We will then send you a confirmation invoice

5. You will also receive an information pack including; destination and challenge information to help you prepare for your challenge

Reserve your place

Personal Details (as on your passport)

Special Dietary Requirements

Friends / Room Sharing

Charity You Would Like To Support

Previous Participation

Where Did You Hear About Challenge For Charity

How To Apply

GOOD LUCK!