Thank you for your interest in taking part in an event for Breast Cancer Now - we'd love to have you on board. To enquire about taking part, please fill in the form below and we will send you more information. Are you a student? Please visit our dedicated events section to find out more about the challenges you can be a part of. What type of event are you interested in? * SelectRunning/Obstacle Course/TriathlonCyclingUK Trek or WalkOverseas Trek or WalkSkydivingSwim When you join our Running Team/ Triathlon Team you will receive: A Breast Cancer Now running vest and iron-on letters A fundraising pack including sponsorship forms and fundraising ideas Training plans and running advice An invitation to join our Running Team Facebook group to chat to our other runners When you join our Cycling Team you will receive: A Breast Cancer Now cycling jersey A fundraising pack including sponsorship forms and fundraising ideas When you join our UK Trekking and Walking Team you will receive: A Breast Cancer Now T-shirt A fundraising pack including sponsorship forms and fundraising ideas When you join our Overseas Trekking and Walking Team you will receive: A Breast Cancer Now T-shirt A fundraising pack including sponsorship forms and fundraising ideas When you join our skydiving team you will receive: A free fundraising pack including sponsorship forms and ideas to help you reach your target More information about our skydiving places can be found here. When you join our team you will receive: A Breast Cancer Now T-shirt A fundraising pack including sponsorship forms and fundraising ideas What running event are you interested in? Select from belowBournemouth Marathon Festival 2017Great North Run 2017Kew Gardens 10K 2017Richmond Half Marathon 2017Royal Parks Half Marathon 2017Tough Mudder London South 2017Tough Mudder North West 2017Tough Mudder Scotland 2017Tough Mudder South West 2017Tough Mudder Yorkshire 2017Tough Mudder HALF London South 2017Tough Mudder HALF North West 2017Tough Mudder HALF Scotland 2017Tough Mudder HALF South West 2017Tough Mudder HALF Yorkshire 2017Bath Half Marathon 2018The Big Half 2018Edinburgh Marathon Festival 5k 2018Edinburgh Marathon Festival 10k 2018Edinburgh Marathon Festival Half Marathon 2018Edinburgh Marathon 2018Other If other, please specify What cycling event are you interested in? SelectEdinburgh Night Ride 2017London to Paris Bike RideRideLondon 46 2017Prudential RideLondon-Surrey 100 2017Vietnam to Cambodia Cycle What UK walking/trekking event are you interested in? Select10 Lakes Challenge 2017The Cotswolds Challenge 2017Cotswold Way Challenge 2017The Fire Hills Challenge 2017The Gower Challenge 2017Hadrian's Wall Challenge 2017London to Brighton Challenge 2017South Coast Challenge 2017Speyside Challenge 2017Thames Bridges or Thames Path Challenge 2017Three Peaks Challenge 2017The Yorkshire Dales Challenge 2017South Devon Coastal Challenge 2018 What overseas event are you interested in? Great Wall of China TrekKilimanjaro Summit ClimbTrek to Machu PicchuVietnam Cycle Challenge What skydiving event are you interested in? * SelectBig Pink JumpSkydiving What swim are you interested in? - Select -Swim Serpentine 2017 Title * SelectMrMrsMissMsDrProfessor First name * Surname * Date of birth Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017 Email * Please tick this box if you would like us to keep you updated by email on our fundraising, campaigning, research and ways you can help. Please tick this box if you would like us to keep you updated by email on our fundraising, campaigning, research and ways you can help. Daytime Phone Number Mobile Number If you are happy for us to contact you by telephone, please tick this box If you are happy for us to contact you by telephone, please tick this box. From time to time we would like to contact you about our fundraising, campaigning and research and ways you can help. But to do so we need your permission. Please tick the box if you are happy to hear from us by SMS. From time to time we would like to contact you about our fundraising, campaigning and research and ways you can help. But to do so we need your permission. Please tick the box if you are happy to hear from us by SMS. Address Address 2 Address 3 Town Postcode From time to time we would like to contact you by post about our fundraising, campaigning and research and the difference your support makes. If you prefer not to be contacted in this way, please tick here. From time to time we would like to contact you about our fundraising, campaigning and research and the difference your support makes. If you prefer NOT to be contacted in this way, please tick here. Do you have personal experience of breast cancer? SelectI currently have breast cancerI used to have/once had breast cancerA member of my family currently has breast cancerA member of my family used to have/once had breast cancerMy friend currently has breast cancerMy friend used to have/once had breast cancerI have lost someone to breast cancerI had a breast cancer scareI have professional experience of breast cancerI have no experience of breast cancerPrefer not to say We will keep a confidential record of your answer if you choose to tell us about your experience of breast cancer. We will take great care to safeguard this information, and process it according to the 1998 Data Protection Act If you are happy for us to contact you and follow you on twitter, please provide your twitter handle How did you hear about taking part in this event for Breast Cancer Now? * SelectFacebookTwitterBreast Cancer Now websiteBreast Cancer Now mailingFetcheveryone WebsiteOtherRealbuzzRunning Bug websiteRunners World MagazineWomen's Running MagazineWomen's Running website Other - please specify Breast Cancer Now will not sell or share your details with other organisations for their marketing or fundraising purposes.
