Boxing Day Dip Signup - Great North Air Ambulance Service

Boxing Day Dip

Name*
Title First Last
Postcode*
Postcode
Address*
Street Address Address Line 2 City Country
My email is*
My phone is*
Date of Birth
This is optional, we only use this information to help understand our supporters and improve their experience
DD slash MM slash YYYY
Where will you be taking part?*
(i.e. Redcar, Hartlepool, Seaham, South Shields)
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Emergency contact name
First name Last name
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Emergency contact telephone
What is your sponsorship target?*
Would you like to order a t-shirt for £10?*
- Yes
- No
What size t-shirt would you like to order?*
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Is admin user
- Yes
How would you like to hear from us?
We'd love to keep you up-to-date with our life-saving missions and how you can help us rescue more people through fundraising, events and volunteering. Please let us know how you'd like to hear from us.
- Email
- SMS
We also communicate with supporters by post or telephone to tell you more about our critical care service and the exciting ways you can support us. You can read more about this in our Privacy Policy or you can click here to not receive communications this way.
Opt-Out of communications by
- Post
- Telephone
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Campaign Link
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Amount