Registration Form - Walk the Wight (main walk across island)

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Your Details    
Title
  
*
Firstname
  
*
Surname
  
*
 
Address
  
*
 
Town
  
*
County
  
Country
  
Postcode
  
*
   
Telephone
   *
Email address
  *
Re-enter email
  *
Date of birth
  *
Walkers under 16 must be accompanied by an adult
Where do you plan to start ?
 
Where do you plan to finish ?
 
   
If you are part of an organised team, give team name
 
   
Travel & Car Park Requirements
Do you require a travel from Southampton ?
 
Do you need car parking ?
 
Do you require a bus to Bembridge start from :
  
Do you require a return bus to Newport from Needles ?
 
Will you be collected from Needles by car ?
 


Conditions: I understand that this is a fundraising event organised by, and for the benefit of, the Earl Mountbatten Hospice. I agree that I will endeavour to raise as much sponsorship as possible and that I will pay the sponsorship money or make a donation to the Earl Mountbatten Hospice by Friday, 27th August 2010.

The organisers expect all entrants to take care when walking and to observe the country code, especially with regard to the control of dogs and dropping litter. Please respect the Highway Code when on the roads, walk in single file and face the oncoming traffic. Walking these distances is a strenuous activity, therefore all participants should be in a reasonable state of health. As the walk crosses countryside it is not suitable for wheelchairs or pushchairs. The organisers cannot be held responsible for loss or damage to personal effects, personal accident, injury or any Public Liability.

I have read and agree to the above conditions

If under 16, as parents we accept the conditions

Thank you for registering - Please allow up to 2 weeks for your walkers pack to arrive.

Every entrant will receive brochures from Red Funnel Ferries. If you would prefer not to receive them in the future, please tick the box.

Please be assured that we will not sell your details to any other organisation. However we would like to contact you about future news and activities for the Earl Mountbatten Hospice and our trading company. If you would prefer not to receive this information, please tick the box

If you would prefer to hear by email, please tick here

Last entry date is Friday, 30th April 2010. Any questions please email info@iwhospice.org or phone 01983 528989.

All fields marked * must be completed.