To register for a free Wonga Walk funraising pack, simply complete this form and click on submit. Name * Address * Postcode * Email * Can we send you email updates on the work of Epilepsy Action and its trading company? No Yes Landline phone number Mobile phone number Can we send you text message updates on the work of Epilepsy Action and its trading company? No Yes Location of walk * Distance of walk * Expected number of walkers participating * Expected date of walk * Is your walk open to the public or a private walk? * - Select -PublicPrivate If you are a member of a branch, please state which one * How did you hear about doing a Wonga Walk? * T-shirt size * - Select -SmallMediumLargeX-Large Please note: only one free T-shirt will be sent to each registered Wonga Walk T-shirt colour * - Select -PinkBlue Which pack? * - Select -IndividualSchoolGroupCompanies We would really like to keep you up to date with the work of Epilepsy Action and 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: No telephone No mail Epilepsy Action privacy policy
