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For family tickets please select 'Family Tcket' on the Colour Blast event page
Address Line 2
ZIP / Postal Code
Adult T-Shirt Size
Child T-Shirt Size
Emergency Contact Name
Emergency Contact Number
Over 18? By ticking this box I confirm that I am over the age of 18 and that I have read and accepted the terms and conditions (see Colour Blast event page) of entry for the walk and the rules and conditions of the event. Under 18? By ticking this box I confirm that I am the parent or guardian of a walker under the age of 16 and that I have read and accepted the terms and conditions (see Colour Blast event page) of entry for the walk and the rules and conditions of this event. Please note: participants under the age of 18 must be accompanied by a registered participant over the age of 18 who will be responsible for said under 18 year old participant.
Name of fee paying adult accompanying child:
Your data... The information we collect on this form is to enable us to effectively manage this event and will only be used for this purpose. Your information relating to this event will only be stored by Dr Kershaw’s Hospice for one year.
However, we would like to keep in touch...
We would like to keep you updated about how your support helps Dr Kershaw’s Hospice. We will only contact you about key achievements, fundraising and how you make a difference to the lives of people with life-limiting illnesses If you are happy for us to keep in touch and retain your information for this purpose, what is your preferred method of contact?
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