Virgin London Marathon

Sunday 22April 2018

Please note: in order for us to allocate our places it is important that you complete all the boxes below

Personal Details

Title (Mr/Mrs/Ms/Miss): / First name:
Last name: / Male/Female: D.O.B:
Address:
Postcode: / Occupation:
Name of company:
Home telephone number: / Mobile telephone number:
Email address: / How long will it take you to complete the marathon?
Where did you hear about the
St Christopher's Hospice team for the London Marathon? / Have you run the London Marathon before? If so, when?
Are you a member of a running club – if so which one?
Please tell us why you want to run for St Christopher's Hospice?
Have you applied for your own place through the official London Marathon ballot?

Fundraising

Have you taken part in a running event for a charity before? If so, which event, which charity, and how much did you raise?
How much do you expect to raise for St Christopher’s Hospice in the 2018 Virgin London Marathon? / Will you be running for more than one charity?
Please tell us how you would raise this amount? / If you were unsuccessfully in gaining one of our London places would you be interested in running another race? (e.g. BUPA 10,000, British 10k)

Declaration

I would like to apply for a place in the 2018 Virgin London Marathon.
I agree to raise the minimum sponsorship of £2,000.

Signed Date

Please return this form to:
Remi Knight, Community Fundraiser, St Christopher's,
51 – 59 Lawrie Park Road, London, SE26 6DZ
If you have any queries, please call Remi on 020 8768 4577 or email her at
  • You must be aged 18 years or older on the day of the marathon
  • Guaranteed places will be allocated in October 2017following the results of the Virgin London Marathon ballot.
  • By accepting one of our guaranteed places, you pledge to raise a minimum of £2,000 (excluding Gift Aid) for St Christopher's.
  • Places are limited and will be allocated on the basis of your completed entry.
  • If you are unable to participate in the marathon for any reason, all donated monies collected in support of St Christopher's must be offered back to the individual sponsors or forwarded to the charity if the sponsors do not want their donations returned.

Thank you for taking the time to complete this form,

Good Luck!

We would like to keep you informed about the work of St Christopher’s and other events in the future. Please tick this box if you would prefer not to hear from us. We will never pass your details on to anyone else.□

St Christopher’s Hospice, 51-59 Lawrie Park Road, LondonSE26 6DZ

Registered charity 210667