Please fill in your details below to receive an Epilepsy Action fundraising pack for the Ride London 100.Contact details Name * Address * Postcode * Telephone number * Email * Send me email updates on the work of Epilepsy Action and its trading company Yes Do you have your own place? * Yes No We will use your contact details to get in touch with you about running events. If you would like us to contact you with information on other Epilepsy Action events, please select 'Yes' above. How did you hear about Epilepsy Action? We would really like to keep you up to date with the work of Epilepsy Action and other ways you can support it, including through our trading company. If you prefer not to be contacted in any of these ways, please tick the boxes below Contact No mail No telephone We will not share your details with anyone else Epilepsy Action privacy policy