The Clatterbridge Abseil Registration

Event Title
Event Date

DayMonthYear
Minimum Age
Maximum Age
Price for Adults
Price for Young Adult (16-17)
Price for Child (5-15)
Infant & Baby (0-4)
Minimum Fundraise Amount
Minimum Donation Amount
Number of people
{eventTitle}
{eventDate}

Book your place with us
Let us know how many people are taking part, including yourself. This event is for supporters 16 and over (age {minimumAge}-17 will require a parent or guardian to consent).
Adult - {priceFor}*
Young Adult (16-17) - {priceFor13}*
Child (5-15) - {priceFor14}*
Infant & Baby (0-4) - {infantamp15}*
Error Message For Maximum People
Error Message for Under 18 Places
Registration total:

{eventTitle}
{eventDate}

It’s all about you
Please complete all this form. If you are booking for more than one person, please ensure that your details are completed first.

The Clatterbridge Cancer Charity is registered in England and Wales with charity number 1202412. We are committed to protecting your privacy and will only use the information that we collect about you lawfully. We may update this Privacy Policy from time-to-time, so please check it regularly.
- First name*
- Last name*
- Address Line 1*
- Address Line 2
- Town*
- County*
- Postcode*
- E-mail address*
  
  Confirmation Email.
- Telephone number*
  Don't include spaces in your telephone numberFormat: 00000000000.
- Help us continue in supporting the 1 in 2 people who will be affected by cancer across Merseyside, Cheshire and beyond. Find out about upcoming events, hear about the latest research and how you can support our life saving work:
  
  Please update me by email
- Change your mind at any time
  
  Contact us on 0151 556 5566 or ccf.tr.fundraising@nhs.net or via this form (Stay In Touch).
  
  Your details are safe with us. Check out our Privacy Policy
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- First name*
- Last name*
- Emergency contact details
  We hope we’ll never need to, but just in case there is a need to contact someone on your behalf during the event please let us know who the best person might be. This person should not be taking part and should be able to represent you and / or your group if applicable.
  
  We promise to keep your details safe. We'll use them to communicate with you in the way(s) that you have agreed to. We will never share or sell your data. For full details, see our privacy policy. If you change your mind about how we contact you, you can contact our supporter care team on 0151 556 5566
- Full name*
- Emergency telephone number*
  Format: 00000000000.
- To take part in this event we need to ensure that you are fit and healthy. If there are any concerns, please select "yes" and complete the details in the box below. This information is confidential and only required for your personal safety.*
  
  YesNo
- Please provide details:*

{eventTitle}
{eventDate}

Your summary
Before confirming we want to check everything with you.

Participant summary

Total participants: {numberOf}

{firstName} {lastName}

{firstName38} {lastName39}

{firstName43} {lastName44}

{firstName50} {lastName51}

{firstName54} {lastName55}

{firstName58} {lastName59}

{firstName62} {lastName63}

{firstName66} {lastName67}

{firstName70} {lastName71}

{firstName74} {lastName75}

{firstName78} {lastName79}

{firstName82} {lastName83}

{firstName86} {lastName87}

{firstName90} {lastName91}

{firstName94} {lastName95}

{firstName98} {lastName99}

{firstName102} {lastName103}

{firstName106} {lastName107}

{firstName110} {lastName111}

{firstName114} {lastName115}

Payment summary
{groupSponsorship}

Do not delete this field

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variable
Total to pay:*

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GBPThank you for supporting Clatterbridge Cancer Charity
Total Amount
Should be Empty:

T-Shirt Size