Abseil St Helier

Friday, 25 April 2025, 10:00 - 17:00

St Helier Hospital, Wrythe Lane, Carshalton, SM5 1AA View Map

My Details

First Name *

Last Name *

Date Of Birth *

Email *

Phone Number *

My Address

Address Line One *

Address Line Two

Town/City *

County

Postcode *

Country *

On the Day

Parental Consent- Participants have to be aged 11+ to take part in the abseil event and require parental permission if 16 or under.

If the participant is under 16, please record the name, relationship and email address of the parent or guardian granting permission. They will also be required to sign a waiver on the day, on behalf of the participant.

If you are wishing to Abseil with a friend or a group, please include names and details.

Please select your first choice of Abseil time slot *

Please select your second choice of Abseil time slot *

What t-shirt size do you require? (T-shirts will be gifted to our top fundraisers) *

Emergency Contact Details

First name: *

Last Name *

Phone Number *

Fundraising

Are you a member of NHS Staff? *

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If there is a particular Ward or Department you would like your fundraising to support, please list it below.

Communication Consent

By registering for this event, you agree to receive updates related to it via email. Please let us know if you are happy to hear from us separately about news, fundraising, events, volunteering opportunities and how your donation is supporting our hospitals by choosing your preferred channel below.

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Abseil St Helier

My Details

My Address

On the Day

Emergency Contact Details

Fundraising

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