Sunday 18 September 20227.30am - 11.30am, City Park, Bradford Your details Date of birth * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year1932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Title First name * Last name * Your email address * Your phone number * Your address Postcode * lookup or enter your address manually Organisation name Address * Address line 2 Address line 3 Town or city Postcode Country Emergency contact number * Are you a member of a running club or organisation? Have you volunteered at this event or a similar event before? * Yes No How would you describe your volunteering experience * Beginner Intermediate Experienced Will you be driving on the day? Yes No Anything we should know? Terms and Conditions: You are at least 16 years of age. You will follow all instructions provided by a member of Epilepsy Action or event staff. If for any reason you are unable to attend, you will inform Epilepsy Action at the earliest opportunity. As a representative of the event and Epilepsy Action, you will not do anything to bring the name or reputation of the organisation or the event into disrepute. Accept terms and conditions * Yes, I accept the terms and conditions We would like to keep you up-to-date about our work. Please tick how you would like to hear from us. * Email Text Phone None of these methods What would you like to hear about? * Ways Epilepsy Action can support me Ways I can help people affected by epilepsy Opt out of post: Post - We would also like to write to you. Please tick if you'd prefer not to get post from us. Tick to opt out of postEpilepsy Action will never swap, share or sell your details. For more information, read our privacy policy.You can update your preferences at any time by contacting our supporter care team on 0113 210 8851 or emailing events@epilepsy.org.uk.Epilepsy Action privacy policy Leave this field blank
