Event registration

Welcome to the Vitality London 10,000 application form.

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

Things to know before filling out this form:

- We have a limited number of guaranteed charity places in the Vitality London 10,000. These are offered on a first come, first served basis via this online form only.

- We ask all runners to pledge to raise £250 for the London 10,000 (excluding Gift Aid).

All applicants must be at least 15 years old as of 1 May 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

Please give details about the reason you would like to run the London 10,000 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 the London 10,000?*

Other*

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

Please list some examples of how you intend to raise this sponsorship:

Would you be happy for us to use your fundraising story in hospice publicity (e.g. to promote our London 10,000 places)?

Yes
No

Does your employer 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 confirm that I wish to participate in the Vitality London 10,000 2022 in aid of Pilgrims Hospices. I confirm that all the information provided by me in this form is to the best of my knowledge true and correct. I understand that if any information provided by me in this form is found to be false, I risk withdrawal from the London 10,000. By taking a Pilgrims Hospices charity place, I pledge to raise £250 for Pilgrims Hospices. (Please tick to indicate that you have read and agree to the disclaimer)*

I agree

London 10,000 application form 2022

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