Gelt Gladiator 2022

About you

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

County/Region

Postcode

Phone*

Email*

Date of birth*

Gender*

Event*

T-shirt size*

Team name

By signing up you are all part of Team EVH/Jigsaw, but we understand you may wish to be part of your own group within that - if you have a group name please put enter it in here

Emergency contact details

These details will only be used in an emergency situation on your expedition and a next of kin needs to be contacted

Contact name*

First Name

Last Name

Contact phone number*

Relationship*

Parent Spouse Other Family Member Friend

Terms and conditions

By ticking the box below you are agreeing to our terms and conditions and therefore pledging to raise a minimum of £50 fundraising for Eden Valley Hospice and Jigsaw.

I have read and understood the Eden Valley Hospice Terms and Conditions*

Yes

Upon completion of this form we will pass your details onto the organisers 'Events Up North'. Please read their entrant terms and conditions here.

I have read and understood the Events Up North entrant Terms and Conditions*

Yes

Please also read through the 'Events Up North' privacy policy by clicking here.

I have read and understood the Events Up North Privacy Policy*

Yes

Additional information

Any additional comments or information that you wish to pass onto the event organiser, such as medical conditions that may affect any help or first aid given to you during the event.