Please complete all fields marked with * Your challenge: The Kiltwalk - Glasgow Your Personal Details Title * Mr Mrs Miss Ms Dr Forename * Surname * Address Line 1 * Address Line 2 Town / City * County Postcode * Gender Female Male Date of Birth (Day/Month/Year) * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 If you are under 16 years of age we are unable to hold your data without your parent's permission therefore we won't be able to send you information about Barnardo's in the future (this includes our enewsletter). You can still donate or find out more information now but we won't be able to contact you again. Daytime Phone No. * Evening Phone No. * Email Address * How did you hear about our Challenge Events? * Challenge Events website Official Event website (eg Virgin London Marathon) Realbuzz Search engine Barnardo's e-newsletter Running website Barnardo's employee Place of work Word of mouth TV/radio Saw Barnardo's at an event Done a challenge event for Barnardo's before Already support Barnardo's Barnardo's Challenge Events brochure Official event magazine (eg Marathon News) Newspaper Other (please specify) Other Have you secured your own place in this event? *YesNo Your Information Barnardo's values your support and promises to respect your privacy. The data we gather and hold is managed in accordance with the Data Protection Act (1998). We will not disclose, or share personal information supplied by you, with any third party organisations without your consent. We would like to contact you about Barnardo's work and fundraising activities. Please confirm that you are happy for us to do this. Yes No
