Event registration

Welcome to the Pilgrims Hospices tandem skydive application form. Thank you for your interest in taking on such a fantastic personal challenge in aid of hospice care in east Kent. We ask all skydivers to pay a £40 deposit and to pledge to raise at least £395 (excluding Gift Aid).

Our skydive places are allocated on a first come, first served basis. After submitting this form, a member of the fundraising team will contact you regarding your requested date's availability and the deposit of £40 taken as necessary at that point.

All applicants must be at least 16 years old as of their proposed skydive date. Weight restrictions also apply.

I'd like to skydive on:*

Sunday 6 July 2025
Sunday 17 August 2025

Have you done a skydive in aid of us before?

Your details

Title*

Other*

First name*

Surname*

Your Gender*

Your date of birth*

Address*

Street Address Address Line 2 City County Postcode

Contact details

Contact mobile number*

Email address*

Enter Email Confirm Email

Must be checked regularly (this is the most effective way for us to communicate with you)

By submitting this form, you consent to be contacted by email for the purpose of this event. If you'd like to receive emails about other exciting ways to support Pilgrims Hospices or with news about our work, please tick the box below.

I am happy to receive emails where possible

You can update your contact preferences at any time by calling our Supporter Relations Team on 01227 782062 or by writing to us at Pilgrims Hospices, Supporter Relations, 56 London Road, Canterbury, Kent, CT2 8JA.

We are registered under the Data Protection Act and will never share, sell or swap your details with any third party for the purposes on their own marketing or the monetising of your data.

About your participation

Emergency contact name*

Emergency contact number*

Are you taking part in memory of a loved one? (If yes, please provide their full name and relationship to you)

eg. John Smith (father)

What is your T-shirt size?

Small
Medium
Large
X Large
XX Large
XXX Large

All tandem skydivers will receive a Pilgrims Hospices t-shirt on the day of their jump.

Where did you hear about our Pilgrims skydive days?*

Other*

Does your company have a match giving scheme that you can apply to in order to boost your fundraising?

Yes
No
Not sure

Name of company/employer

I commit to raising £395 for Pilgrims Hospices. I agree to forward at least 50% of my sponsorship (£200) to Pilgrims Hospices no later than 4 weeks before the date of my skydive. I understand that I take part in this event at my own risk and that the organisers will not be liable for any injury or illness except where injury or illness is caused by their negligence and they are legally liable. I agree to abide by any terms and conditions of the event as agreed by the organisers (Skydive Headcorn and Pilgrims Hospices). I agree to follow any and all safety instructions given by the organisers before and during the event. By taking part in the event, I agree to Pilgrims Hospices using my name and any footage or photographs taken during my participation to be used in any future promotional material. (Please tick to indicate that you have read and agree to the disclaimer)*

I agree

Tandem Skydive application form

Care for you