London Triathlon 2019: Own Place registration

First Name *

Last Name *

Date of Birth *

Day

Month

Year

Gender

Email *

Phone Number *

Postcode

E.g. WC1R 4TH (inc. space)

Street Address *

Street Address Line 2

Town/City *

Post Code *

District/County *

Please select your T-shirt size *

Have you been affected by a blood cancer? *

Which blood cancer?

Occasionally Bloodwise may want to share the story of why you're taking part in this event, to help publicise the vital work we do. We'll always seek your permission to do this by email or phone before releasing your story. Please indicate below if you'd be happy to share your story. *

Tell us your story

In ticking these boxes, you're agreeing to the following things: *

I agree to the terms and conditions of this event

I agree I am of the age required to participate in this event

I agree to actively fundraise on behalf of Bloodwise

I / We confirm I have secured my own place for this event

As a supporter, you’re at the heart of everything we do. We’d love to keep you updated about our exciting work and the ways you can help, including campaigns and events that you might be interested in. We promise to respect your privacy and we will never sell or swap your details.

I am happy for Bloodwise to contact me by:

Email

Phone

Post

SMS