Hackney Half - charity place registration

Your details

First Name

Surname

Phone number

Date of birth

Are you currently a Barts Health NHS Trust staff member

YesNo

Which hospital do you work for?

Your Address

Enter Manually

Postcode

Address (Line 1)

Town or City

County

Country

Address (Line 1)

Town or City

County

Postcode

Country

Your Fundraising

Please confirm that you agree to the following statements:

Fundraising registration fee

I will pay a non-refundable registration fee of £20

Fundraising declaration

In addition, I pledge to raise a minimum of £300 in sponsorship (excluding Gift Aid) and return all funds raised to Barts Charity within six weeks of my participation in the Hackney Half Marathon

We'd like to send you a Barts Charity running vest or a running T-shirt to show your support on the day. Please let us know which one you'd prefer:

Please indicate your preferred size:

Share the reason why you're fundraising for Barts Charity:

Tell us a little more about why you want to run for Barts Charity.
Please note, the success of your application will be assessed on this information.

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Keeping in touch Thank you so much for your support. We’d like to keep you updated with our latest news, how your support is making a difference, as well as ways you can support or get involved in the future. You can change how you hear from us at anytime. Please tick the relevant boxes:

By submitting this form you agree to our event terms and conditions and consent to us using your details to provide you with information about the event you are entering.

As a supporter of Barts Charity we'll keep you updated by post but if you'd rather not hear from us in this way, please let us know by emailing hello@bartscharity.org.uk or by calling us on 020 7618 1720.

We'll always keep your details safe and secure and will not sell or swap your details with anyone. For more information you can read our Privacy Statement or call the number above to receive a copy in the post.

Contact Information