2019 Event Registration | Cancer Brown Dog

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Fields marked with an * are required

Registration must be accompanied with payment to confirm your place.

Challenger Information

First Name *

Last Name *

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:

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) *

Terms and conditions

Please tick that you accept these terms and conditions.

I will be 18 or over on 14th June 2019: *

I agree to raise as much money as I possibly can: *

I agree to aim to raise as much money before the event as I can and as early as possible: *

I agree to use My Donate to raise money (unless this is not practical or possible to me): *

I agree to read the information pack provided: *

I understand that I need to bring sufficient water (in line with quantities highlighted in the information pack) and food to get me through the challenge: *

I accept that this is not an easy challenge and as such I agree to train for the event and get appropriately fit / prepared: *

I understand that I have to organise my own accommodation (note – the Falcon Inn at Bude is offering Brown Dog a special rate of £100 a night instead of £140. Alternatively there is a Premier Inn at Bude): *

Payment

Any special dietary requirements for the Dogs Dinner? (write none if you have none) *

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Total Cost: £78.00 Please confirm challenge and proceed to payment page by selecting the submit button.

**Please check your spam if you haven’t received the confirmation e-mail after you’ve pressed the above submit button