2024 The Malvern Hills Challenge registration – Pay by standing order

Your place at the event will be confirmed once your first monthly standing order being received by Brown Dog.

Challenger Information

First Name *

Surname *

Mobile Number *

Your gender *

Email *

Confirm Email *

Select the event you wish to participate to *The 10-mile Malvern Hills WalkThe 20-mile Malvern Hills WalkThe price of the Challenge is the same whether you select the 10-mile or 20-mile Walk. You choose for your own ability.

Will you attend the event(s) with a family member or friend?YesNo

Full name of accompanying family member or friendFor our information only. Each person who registers must complete an individual registration form

Do you have any medical conditions we should be aware of? *YesNo

Please provide details of your medical conditions *

In case of an emergency, we would call your next of kin. Please provide a full name and phone number below (By providing these details, you authorise us to contact your next of kin for emergency purpose only)

Full name of next of kin *First name & surname

Contact number of next of kin *Must be different to your own number

Have you participated in a Brown Dog Challenge before?YesNo

Tell us the full name of our Brown Dog organising team member (so we can thank them!) *

Terms and Conditions

It is really important that you read all the following terms and conditions before ticking the box below to accept them:

I confirm that I will be aged 18 or over on the 8th June 2024
I agree to raise as much money as I can
I agree to use Just Giving to raise my money, and if I cannot use Just Giving I will contact Brown Dog
I agree to read the Information Pack that will be provided for the Challenge
I agree to follow all safety & guidance instructions on the day.
I understand that I need to bring sufficient water and food for myself on the day
I agree to suitably train for this event to enable me to meet the required pace
I accept that this is a team event, whereby the whole team start together, walk together and finish together
I understand that I will need to organise my own accommodation over-night (if appropriate)

Are you already registered in our marketing database? *YesNo

Do you want to receive our latest email marketing news like invitations to the Brown Dog challenges and updates on our fundraising? *YesNoWe will not share your personal data with any third parties and you can unsubscribe at any time by contacting us using our online Contact Form (https://cancerbrowndog.co.uk/contact/) or email browndog@cancerbrowndog.co.uk

Additional comments

YOUR DOGS DINNER MEAL SELECTION

Choose one starter, one main and one dessert. Included in the price of the Challenge

StartersBroccoli and Stilton Soup, stilton cream, broccoli florets (v)Ham Hock & Pea Terrine, piccalilli, tendrils pea shootsDeep Fried French Brie, fig chutney (v)Smoked Mackerel Pate, toasted brioche, red onion chutney, rocketRomanesco, cauliflower cumin puree, walnuts, crisps (vg)

MainsBraised Beef Blade, dauphinoise potato, carrot, savoy cabbage, charred shallots, reduced braising liquorChicken Breast, mozzarella & green pesto stuffing, Parma ham, fondant potato, tomato & basil sauceHerb Crusted Cod, Samphire, cauliflower pureeSquash, Pine Nut & Sage Risotto, parmesan & seed crisp. micro herbs (v)Braised Aubergine Steak, herb polenta, red wine & mushroom jus (vg)

DessertsLemon Tart, raspberry sorbet (v)Chocolate Brownie, vanilla ice cream (v)New York Cheesecake, strawberries & mint (v)Steamed Treacle Sponge Pudding, vanilla "ice-cream" (vg)Cheese Board, Worcester gold, Shropshire blue, Somerset Brie, crackers, celery, apple, grapes, chutney

COST

Do you want to purchase a Brown Dog T-shirt? *

Select the size of your T-Shirt (from the dropdown menu): *

Total cost payable for the event

By clicking the "REGISTER" button below, you agree to complete your registration and to pay the total cost by standing order before or on 1st June 2024. Instructions to set up the standing order will be included in your confirmation email.