2018 Event Registration Registration must be accompanied with payment to confirm your place... If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required First Name * Last Name * Male or Female? Male Female Email * Email Verification * Phone * Is this your first Brown Dog Challenge? If yes, do you have a connection with any of the organising team? If so, write their name in the box below: How did you hear about the Brown Dog challenge? * Website Facebook Page Leaflet Previous Challenger Which challenge do you want to join? * 40 mile (2 day) - £62 20 mile (1 day) - £52 11 mile (1 day) - £57 Ground Support - £42 Any medical conditions we should be aware of? (write none if you have none) * Next of kin name * Contact number of next of kin? (MUST BE DIFFERENT TO YOUR OWN NUMBER -for emergency only) * What is your t-shirt size? (Included in event cost) * Small Medium Large Extra Large Extra Extra Large Do you want to join our Dogs Dinner Celebration meal at the Imperial Hotel that includes a 3 course silver service for £25? * Yes No Any special dietary requirements for the Dogs Dinner? (write none if you have none) * I will be over 18 on the day of the challenge * I agree to take responsibility for my own safety * I'm making a commitment to raise as much money as possible for Brown Dog * Fundraising Method * I will be setting up a My Donate account for donations (Our preferred method) Sorry, My Donate doesn't work for me, so I’ll use the sponsorship form I know I have to make my own arrangements for accommodation * Other comments I would like to receive information and news from the Brown Dog. Yes please No thanks Total Cost: £87.00 Please confirm challenge and proceed to payment page by selecting the submit button.