JOIN OUR RANKS! SPARTAN RACE EDINBURGH 18-19TH JULY … · JOIN OUR RANKS! SP ART AN RACE EDINBURGH 18-19TH JUL Y 2015 OFFICIAL CHARITY PARTNE R Please complete this form in BLOCK

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JOIN OUR RANKS! SPARTAN RACE EDINBURGH 18-19TH JULY 2015OFFICIAL CHARITY PARTNER

Please complete this form in BLOCK CAPITALS and send it together with your registration fee made payable to ‘ProjectScotland’. Please email [email protected] should you wish to pay by bank transfer, and we will send you the details.

GENERAL DETAILSName .............................................................................................................................................................................................................

Address .........................................................................................................................................................................................................

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Telephone .................................................................................... Email Address ..................................................................................

Please ensure that these are your main contact details as we will be using them to send up-to-date information about the event.

DOB ........................................ (Spartans must be 14 years old on race day. Under 18’s will require a parent/guardian present to sign a waiver.)

T-Shirt Size: Male S M L XL Female S M L XL

Job Title .................................................................................. Company Name ...........................................................................................................

Does your company run a matched giving scheme? Yes No

Does your company know that they have a Spartan in their midst? They may be interested in hearing about ProjectScotland and our amazing work, so why not ask them if

they’ll match what you raise? Double your money? Yes please!

How did you hear about the ProjectScotland Spartan Army?

Word of Mouth Online Social Media Press Other Please give details

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HOW WILL YOU FUNDRAISE?If you join our Spartan Army, you will commit to raising a minimum sponsorship of £250 for ProjectScotland. To secure your place you will also be required to pay a £35 registration fee.

Please outline below how you plan to raise your sponsorship money (please note Gift Aid cannot be used to reach the minimum sponsorship amount)

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Have you raised money for a charity in the past? Yes No How much did you raise? ......................................................

Why would you like to fundraise for ProjectScotland? ............................................................................................................................

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For Office Use Only:

Registration Fee

Date received

Good news! If you have already got your own place then you can still be part of the ProjectScotland Spartan Army. Just [email protected] so we can arm you with a Spartan kit!

ProjectScotland is a Scottish registered charity (SC035464) and is a company limited by guarantee (SC267476) with its registered office at 20 Hopetoun Street, Edinburgh, EH7 4GH.

W: www.projectscotland.co.uk E: [email protected] Follow us on Twitter @projectscotland

MEDICAL HISTORY & NEXT OF KINTaking part in a challenging event can put a great strain on your body and undertaking such an activity should not be taken lightly. If you have never done anything like this before you should seek medical advice regarding your fitness and training programme. Please note that by signing the declaration below you are confirming that to the best of your knowledge your state of health and fitness is good and that you take full responsibility for yourself.

Please give details of any medical conditions ............................................................................................................................

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Emergency Contact Name .……................................................ Relationship to participant ....………………………………….

Daytime Telephone…………………………………………… Mobile…………………….……………………………………………..

Email……………………………………………………………………

REGISTRATION PAYMENTI have enclosed my £35 registration fee (Cheques should be made payable to “ProjectScotland”).

Please invoice me for my £35 registration fee.

I wish to pay by bank transfer; please send me the details.

I require a receipt.

DECLARATIONAfter submitting your application you will be sent our Fundraising Agreement. By signing you agree to our Fundraising terms and conditions

• I understand that the objective is to raise as much sponsorship as possible for ProjectScotland. • I understand that the challenge will involve strenuous activity and that I need to achieve an adequate level of fitness in order to participate. • I understand that I must raise a minimum of £250 sponsorship, and my final sponsorship monies must be submitted by 18th September 2015. • Before the event, if I have any concerns about my physical fitness or health, or any of the medical conditions above that may affect my safe participation, I will consult with my doctor. • I understand that ProjectScotland cannot take responsibility for any injury, losses or damage caused or sustained as a result of fundraising events held in aid of ProjectScotland. It is the responsibility of the event organizer to comply with legal and safety regulations. The event organizer is Spartan Race.

Print name: ....................................................................... Date: ........................................

Sign: ..........................................................................................................................

DATA PROTECTIONYour details will be kept by ProjectScotland to determine the allocation of the Spartan Race places. We value your support and promise to respect your privacy, as such the data we gather and hold is managed in accordance with the Data Protection Act (1998). ProjectScotland will not share your details with any other organisation other than the event organiser. Please tick below if you are happy for us to inform you about our work and ways you can support us in the future.

Please contact me by: Email Text Phone Post To complete your application please return this form to [email protected] quoting ‘Make me a Spartan’ or post to the address below, for the attention of The Fundraising Team.