Sign up today! :: NorthCare Charity

Title

First name Required

Last name Required

Date of Birth Required

Email address Required

Contact number Required

Are you a member of a local Slimming World group?

If yes, please tell us what group you're a member of

Tell us how you'll be completing your miles Required

Walk or step count

Run or jog

Swim

Cycle

Other

Tell us how many miles you aim to complete in November (Don’t worry, we can help you work this out if you’re not sure yet!)

Declaration Required

I confirm all funds are voluntarily given and accepted without expecting or receiving something in return. I will comply with fundraising laws and recognised fundraising standards when organising any fundraising activities.

Want a free charity t-shirt? Please select a size

Contact information Required

I confirm NorthCare Charity can contact me about my participation in this event via the details I have provided in this form. I hereby declare that all personal information is voluntarily given and is accurate to the best of my knowledge.

I agree to receive NorthCare Charity’s newsletter to my email address so I can find out how my support helps patients and staff across the Northern Care Alliance. I understand I can unsubscribe at any time by emailing northcarecharity@nca.nhs.uk

Sign up today!

SIGN UP TODAY BY COMPLETING THE FORM BELOW, we can't wait to have you on board!

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