Great North Run 2022 - Own Place participant
1. Personal details
Great North Run 2022 - Own place declaration
I have gained my own place through the official ballot scheme and would like to take part on behalf of Meningitis Now
Title
Please select...
Mr
Mrs
Miss
Ms
Mx
First Name
Last Name
Phone
Whichever is your preferred number
Email
Date of birth
Must be 18 or over on 11 September 2022
Street Address
Town or City
Postcode
In the event of an emergency please contact (Please note this cannot be another participant in the race):
Name
Relationship to you
Please select...
Husband
Wife
Partner
Mother
Father
Daughter
Son
Sister
Brother
Guardian
Other family member
Friend
Nephew
Niece
Uncle
Aunt
Grandparent
Contact number
Your meningitis experience
Please select...
Personal experience
Family experience
Friend/Colleague experience
Nursery experience
Pupil/Student experience
Employee experience
Professional experience
No experience
Other
Other meningitis experience details
How did you hear about this event?
Please select...
Leaflet
Email
Facebook
Other website
Meningitis Now website
Previous participant
Friend/family
Other
If other please state
2. Running Top Details
Please select the size of your running vest
Please select...
Small
Medium
Large
X-Large
What name would you like on your vest?
Maximum 10 characters
3. Keep in touch
Please let us know what you'd like to hear about
Get Informed: Meningitis information
Get Support: How we support those affected by meningitis
Get Involved: How you can support us
All the above
I don't want to hear from you
Meningitis Information:- includes updates about the impact of the disease, vaccine programmes, our campaigns, and media activity........ How we support those affected:- includes our Family Days, Believe & Achieve weekends, Forever Days, invitations to some key events organised by us e.g. Christmas Carol Concerts...... How you can support us:- includes information about donating your time through volunteering or organising fundraising activities, how to get involved by taking part in an event such as Three Peaks Challenge, or our Five Valleys Walk and how you can donate to us through our cash appeals, or by purchasing merchandise e.g. Christmas cards
x
And please let us know how we can contact you
Email
Post
Telephone
We will only communicate with you about the aspect(s) of our work you’ve requested, in the way(s) that you have requested. We may also contact you for administrative purposes or to fulfil a service or request. We never sell our supporter data and only share this with suppliers helping us in our cause. To find out more about how we process personal data and respect your rights, please visit our
privacy policy
.
By submitting you agree to the below Terms and Conditions
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