Race to the Base - Form - Great North Air Ambulance Service

How will you be taking part in the event?*

Business name*

Team name*

How many entries would you like to purchase?*

Each entry is £10 and each participant will receive a medal at the end of the challenge.

Team leader contact details

Name*

Title First name Last name

Email*

Phone*

Team member names*

First name	Last name

Business address

Address*

Postcode

Address*

Street Address Address Line 2 City Country

About your challenge

What distance is your challenge?*

How will you carry out your challenge?*

Please tell us how you will be completing your challenge*

What is your fundraising target?*

We ask you to raise £50 in sponsorship.

Hidden

How do you plan to fundraise?*

Other*

If you have any other information which might be useful, please provide details below

Are you a former patient of the charity or know someone who is?*

Yes
No

Please tell us your connection with GNAAS*

Hidden

Is admin user

Yes

Staff Marketing Consent Script
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. Would you prefer this by email, SMS or both?

We may also occasionally contact you by post or phone. You can tell me now or at any point in the future if you’d prefer us not to do this. [For background – it is unlikely that we would contact them more than four times a year by phone/post]

How would you like to hear from us?

We'd love to keep you up-to-date with our lifesaving 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

Hidden

Quantity*

Hidden

Campaign Link

Hidden

Date