Event registration

Welcome to the Virtual TCS London Marathon application form.

Thank you for your interest in running in aid of Pilgrims Hospices.

Things to know before filling out this form:

- We only have a limited number of places available in the Virtual TCS London Marathon, and will therefore be offering these places on a first come, first served basis.

- We ask all runners to pledge to raise at least £100 for their place in the Virtual TCS London Marathon (excluding Gift Aid).

All applicants must be at least 17 years old as of October 2022.

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*

Please give details about the reason you would like to run the Virtual London Marathon in aid of Pilgrims Hospices.*

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)

Where did you hear about our charity places in Virtual London Marathon?*

Other*

Do you have a sponsorship target you would like to achieve?

We ask you to pledge to raise at least £100 (exc. Gift Aid)

Would you be happy for us to use your fundraising story in hospice publicity (e.g. to promote our Virtual London Marathon places)?

Yes
No

Do you have any health conditions we need to be aware of?*

No
Yes

Please list health conditions here*

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/emploer

I pledge to raise at least £100 for Pilgrims Hospices. 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. I undertake at all times to behave responsibly. 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