Individual and Team Leader Entry Form - Step 1

 

You can register online for the Chilterns 3 Peaks Challenge.

 

The entry fee is £15 per adult, which includes your T-shirt. For children aged 15 and under the entry fee is £7.50. Payment can be made securely using your credit or debit card via Sage Pay, our secure payments service.

 

Back for 2011 by popular demand

As well as the 5 & 9 mile options we are also offering challengers the option of taking on the entire 18 mile trek between Princes Risborough and Ivinghoe Beacon along the Ridgeway path – without the bus transfer from Wendover. Return transport to Princes Risborough will be provided from Ivinghoe Beacon.

 

Please fill in the form below. You must be 18 years or over and in possession of a valid credit or debit card to register online.

 

Fields marked * are mandatory

 

Title * Mrs / Miss / Ms / Mr / Other

First Name *

Surname *

Address line 1 * (This should be the address to which your credit card is registered)

Address line 2

Post Town *

Post Code *

Email Address *

Phone Number (home) *

Phone Number (mobile)

Date of Birth

Emergency Contact Name*

Emergency Contact Number *

T Shirt Size * S M L XL

 

Where did you hear about The Chilterns 3 Peaks Challenge?

Are you bringing your dog? N Y If so, how many? Places for dogs may be limited owing to transport restrictions, register early to avoid disappointment.

Team Name If you wish to register multiple people as a single team, or if you wish to join a team that has already been registered, please put the team name in the box below.

We are loking for help with publicity for the Chilterns 3 Peaks Challenge:

1. Tell us your story - why are you taking part? Are you doing anything interesting to raise money?

   Are you happy for your story to be used in publicity around the event? Y N 2. Spread the word - would you be willing to use Facebook and other social networking sites to spread the word? Y N 3. Do you belong to a club or work for an organization who would be interested in finding out more about the charity?

 

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