Step 1 of 3 33% Name* DrMissMrMrsMsMxProf.Rev.Other Prefix First Last Address* Street Address Address Line 2 City Post Code Mobile*Email* Date of birth* DD slash MM slash YYYY Gender* Male Female Non-binary Other Prefer not to say Unknown Occupation*Employer*Does your company run a matched-funding scheme?* Yes No Don't know - I'll ask Match funding is where your employer matches funds you raise, often £ for £ and sometimes up to a set amount for a charitable organisation, enhancing the amount you can raise for Shaftesbury!If you have a good personal story to tell, would you be happy for us to share this with your local media? Always and only in collaboration with you:* Yes No How did you hear about running this race for Shaftesbury?* Google Previous Shaftesbury runner Personal recommendation Shaftesbury website Shaftesbury enewsletter Facebook Twitter Other social media Do you have any special requirements that we need to know about i.e. allergies, medical conditions?*If offered a place with Team Shaftesbury you would need to pledge to raise a minimum sponsorship of £350 for Shaftesbury (excluding Gift Aid). If you’re happy with this, please tell us how you’d fundraise:*Have you applied for a Ballot place?* Yes No Terms & Conditions If you are successful in securing a Shaftesbury place through the application process the registration fee of £30 is non-refundable and this must be paid within 7 days of accepting your place. You must agree to raise the minimum of £350 (excluding Gift Aid). All donations online and offline should be sent in no later than six weeks after the event. By accepting a charity place, you understand that Shaftesbury has the right to withdraw your place at any time with due warning, if they consider that you are not committed to raising the pledged sponsorship. Shaftesbury does not take responsibility for any health issues during your training for the event or any incidents that occur on race day. If you have any health concerns prior to, or during, your training please consult with your doctor. Shaftesbury reserves the right to refuse an application at its absolute discretion. You must meet the minimum age requirement set by the event organisers to take place If you are unable to participate in the event for any reason, all donated monies collected in support of Shaftesbury must be forwarded to the charity or returned to the individual sponsors. Monies already received by the charity will not be refunded. By signing up to a charity place with Shaftesbury, you are consenting to Shaftesbury using any images of you in their promotional materials. Please contact us in advance of the event if you are unhappy with this arrangement. Declaration* I agree to these terms and conditions Privacy policy* I am happy to consent to the Shaftesbury Cookies and Privacy policy (click here to read this policy). Sharing your details* Please note we may need to share some of your personal details with the event organiser to secure your guaranteed charity place. We will never share, sell or swap your details with a third party for the purposes of their own marketing or the monetising of your data. We’d like to keep in touch and let you know how your support is transforming the lives of people with disabilities. We'll share more on our work, events and ways you can get involved. If you have supported us before we’ll continue to contact you in this way unless you tell us otherwise. Yes, please keep me updated by email Yes, please keep me updated by phone Yes, please keep me updated by text If you would rather not hear from us, or would like to change how we contact you, please do call our friendly supporter services team on 020 7452 2121 or email us at supporterservices@shaftesburygroup.org. Taking care of your information is important to us. Information about how we protect and use your personal data is set out in our privacy policy at dataprotection@shaftesburygroup.org
