Santas on the Run! Herne Bay Registration Form 2023 Welcome to the registration form for Santas on the Run! taking place in Herne Bay on Sunday 10th December 2023. The following form can be completed to register a family entry (2 adults, 2 children) or up to four individuals. A child is any participant under the age of 18 on the event date. Closing date for early bird registrations: Sunday 22nd October 2023. Closing date for advanced registrations: Sunday 3rd December 2023.I am registering for Santas on the Run! as...* As an individual / group of individuals As a family (2 adults, 2 children under 18) Advanced family entry (2 adults, 2 children under 18) Price: Participant 1*Please select the appropriate entry for participant 1. Adult Child (under 18) Adult advanced entry Price: Child advanced entry Price: Your detailsTitle*MrMissMrsMsMxDrOtherOther* First name* Surname* Your gender?*Please selectMaleFemaleNon-binaryTransgenderPrefer not to sayYour date of birth* DD slash MM slash YYYY Under 18s must be accompanied by a participating adult and supervised at all times.Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Contact detailsMobile (important on the day)*Email address (for your event confirmation and updates about the event)* Enter Email Confirm Email 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 the address at the foot of this webpage.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 participationWhich route will you be running?* 3 km 5 km 10 km Are you taking part in memory of a loved one? If so, please provide their full name and relationship to you eg. John Smith (father)If you're part of a team, what is your team name? Do you have a sponsorship target you would like to achieve? Emergency contact details Please provide a contact name and telephone number for use in any emergency.Emergency contact name* Emergency contact number*Where did you hear about the event?*Please selectPoster/flyer/bannerPilgrims Matters magazineInternet searchSocial mediaWebsiteEmailPostPilgrims volunteerWord of mouthOtherOther* Would you like to register a second person? Yes Details for the second participant Details for the second adult participantParticipant 2*Please select the appropriate entry for participant 2. Adult Child (under 18) Adult advanced entry Price: Child advanced entry Price: Title*MrMissMrsMsMxDrOtherOther* First name* Surname* Gender*Please selectMaleFemaleNon-binaryTransgenderPrefer not to sayDate of birth* DD slash MM slash YYYY Under 18s must be accompanied by a participating adult and supervised at all times.Address (second registrant)* Same as lead participant Street Address Address Line 2 City County / State / Region ZIP / Postal Code Telephone*Email* Enter Email Confirm Email Which route will they be running?* 3 km 5 km 10 km Are they taking part in memory of a loved one? If so, please provide their full name and relationship eg. John Smith (father)If they're part of a team, what is the team name? Emergency contact name* Emergency contact number*Would you like to register a third person? Yes Details for the third participant Details for the first child participantParticipant 3*Please select the appropriate entry for participant 3. Adult Child (under 18) Adult advanced entry Price: Child advanced entry Price: Title*MrMissMrsMsMxDrOtherOther* First name* Surname* Gender*Please selectMaleFemaleNon-binaryTransgenderPrefer not to sayDate of birth* DD slash MM slash YYYY Under 18s must be accompanied by a participating adult and supervised at all times.Address (third registrant)* Same as lead participant Street Address Address Line 2 City County / State / Region ZIP / Postal Code Telephone*Email* Enter Email Confirm Email Which route will they be running?* 3 km 5 km 10 km Are they taking part in memory of a loved one? If so, please provide their full name and relationship eg. John Smith (father)If they're part of a team, what is the team name? Emergency contact name* Emergency contact number*Would you like to register a fourth person? Yes Details for the fourth participant Details for the second child participantParticipant 4*Please select the appropriate entry for participant 4. Adult Child (under 18) Adult advanced entry Price: Child advanced entry Price: Title*MrMissMrsMsMxDrOtherOther* First name* Surname* Gender*Please selectMaleFemaleNon-binaryTransgenderPrefer not to sayDate of birth* DD slash MM slash YYYY Under 18s must be accompanied by a participating adult and supervised at all times.Address (fourth registrant)* Same as lead participant Street Address Address Line 2 City County / State / Region ZIP / Postal Code Telephone*Email* Enter Email Confirm Email Which route will they be running?* 3 km 5 km 10 km Are they taking part in memory of a loved one? If so, please provide their full name and relationship eg. John Smith (father)If they're part of a team, what is the team name? Emergency contact name* Emergency contact number*I would like to add a donation to my entry of:Please select£12 could pay for a patient's meals for the day£25 could pay for an hour of nursing care£35 could pay for therapy sessions for patients and carers£50 could pay for essential nursing suppliesOther amountPlease enter your chosen donation amount:* Gift Aid - Increase the value of your gift by 25% Yes. Please treat all donations I make now, in the future, or have made to Pilgrims Hospices for the past 4 years as Gift Aid donations until further notice. I am a UK taxpayer and understand that if I pay less income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference. I understand that Pilgrims Hospices will reclaim 25p of tax on every £1 that I have given. I am not a UK Taxpayer Total £ 0.00 Disclaimer* I understand that I take part in the event(s) at my own risk and that the organisers will not not liable for any injury or illness except where injury or illness is caused by their negligence and they are legally liable. I confirm that all the information provided by me in this form is, to the best of my knowledge, true and correct, and that providing false information may affect my participation. I agree to abide by any terms and conditions of the event(s) as agreed by the organisers and that fellow participants aged under 18 will be supervised by an adult at all times. 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(s). By taking part in the event(s), 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). Terms and Conditions* I have read and agree to the Terms and Conditions of entry.