Register your challenge

Please fill in the form below to tell us about the event you are taking part in to help Woking & Sam Beare Hospices. We would like to support you as best we can with your fundraising efforts.
- - Woking & Sam Beare Hospices cannot accept responsibility for accidents, injury or loss incurred as a result of you taking part in your event. Please consult your doctor prior to entering any challenge event if you are not sure that you are fit or well enough to complete it.
- - Please fill in all mandatory fields with a * next to them
- - Once you have filled in this form the Events team will contact you within 5 working days. Thank you for supporting the hospice.
New legislation means we can no longer process third party data. Each participant will therefore need to fill in their own form. If you are younger than 16 years of age, please ask an adult to fill in this form for you.
Personal information
Please enter your contact details below
Title*
Name*

First name

Last name
Email*

Enter Email

Confirm Email
Date of birth*
Phone*
Address information
Address*

Street Address
Address Line 2
City
County
Postcode
Country
About the event you are participating in
What is the name of the event or what is your challenge/target?*
What is your fundraising target?*
How did you hear about the hospice?*
Are you taking part in memory of someone the hospice has cared for?
If so, please let us know their full name so we can accredit your sponsorship to their tribute fund.
Staying in touch
Legislation means that you actively have to select what information you would like to receive from us in the future, and also how you will receive it, otherwise we won't be able to contact you. If you are already receiving communications from us you can use the tick boxes below to specify what you would like to hear about in the future. Please note, what you select below will supersede any previous choices. Woking & Sam Beare Hospices will never sell or swap your details with another organisation for marketing purposes. We will treat your details in confidence and in accordance with data protection legislation. Further information on how your data is used and stored can be found here
Can we contact you via email regarding other hospice updates?*
If you select yes you will be able to specify what you would like to receive.
- Yes please, I would like to hear from you by email
- No thank you, please do not contact me by email
Please select what you would like to be kept informed about by email
If none are selected you will not receive any additional communications from us.
- Email newsletter
- Fundraising events
- Fundraising appeals
- Volunteer opportunities
- Lottery and raffles
Please be aware that if you select 'no', we will not be able to email you about other future fundraising events, news or any of the other options listed below. However you can always return to this page and update your contact preferences.
Postal options
Please tick here if you would prefer NOT to receive anything from the Hospice through the post.
- Please do not send me anything by post
You can also find information about these topics on our website by following these links: Fundraising Events Fundraising Appeals Volunteering Lottery and raffles

Personal information

Address information

About the event you are participating in

Staying in touch

Keep up to date with hospice news and events