مشروع تمكين العائلة

First Name*

Last Name*

Email address*

Address*

Street Address Address Line 2 City ZIP / Postal Code Country

Gender*

Male
Female

Contact Number

Date of Birth (DOB)*

If under 16, they must be accompanied by an adult. Please state the name and contact number of the adult attending

Emergency contact information. (Please provide details of the name, contact number, and the relationship to you)*

Please state your medical history and/or any recent injuries. (If none, please state n/a)*

Are you taking any medications? (Please specify below)

Do you have any allergies? (if yes, please provide info below)

Is there any conditions that may affect your climb, or you feel that we should know about?

Will you require transport from Manchester?*

Yes, I will require transport
No, I'll prefer to make my own arrangements

How did you hear about this challenge?*

Social media
Word of mouth
Website
Other

We would love to keep you updated about our ongoing projects and how we together can make a difference. Opt out below if you do not wish to be contacted by the methods below

Email
SMS
Phone

Would you be interested in being a GRF volunteer to help out with future events, programmes and activities?*

Yes
No

Coronavirus

We will take all the relevant precautions based on the Government guidelines. In the scenario, where you have Covid-19 or you come in contact with someone with Covid-19 and have been instructed to self-isolate within 7 days of the departure of the event. Please get in contact with a member of our team by calling 0161 3027888, who will be able to assist you and provide guidance.

Photography and Videography

There may be a photographer at this event, where GRF may use this imagery to market future events both on and offline. If you do not wish for your photograph to be taken and/or used, please inform a relevant member of the team on the day.

Challenges include activities which may include a serious risk of injury to health. Participants should accept these risks, be responsible for their own safety and take their own necessary precautions in order to prepare for the event. GRF cannot accept any responsibility to injury which may occur on the activity.

I am submitting all the above information to be true and correct at the time of submission and I agree in intending to raise the set minimum fundraising target.

Registration Fee*

Price:

Credit Card*

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Coronavirus

Photography and Videography

Coronavirus

Photography and Videography

Payment Details

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