Medal Mission: The Best of Brum Challenge

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My Details

First Name *

Last Name *

Date Of Birth *

My Contact Details

Email *

Phone number

My Address

Address Line One *

Address Line Two

Town/City *

County

Postcode *

Country *

We'll send your fundraising pack to this address in the post. If you'd prefer to just have your fundraising pack digitally via email, tick here.

My Mission

Please confirm which distance you would like to complete. The challenges are:

Complete Best of Brum Challenge: 360 miles
Jewellery Quarter Challenge: 40 miles
Digbeth Challenge: 60 miles
Canal Challenge: 100 miles
Bullring Challenge: 160 miles

I would like to complete (mi) *

When do you plan to start your mission? *

When are you aiming to complete your mission by? Don't worry if you don't know yet, you'll find some top tips and suggestions for how to break down your challenge in your fundraising pack.

How are you planning to complete your miles? *

T-shirt size *

How did you hear about Medal Mission?

Keeping in Touch

By signing up to this campaign, you are consenting to receiving ALL information about this campaign. We would ALSO like to keep in touch with you about our vital work and update you on our news and fundraising activities. Please tell us if you would be happy for us to contact you:

By email

By SMS

We may also contact you by telephone and/or post. If you wish not to be contacted by post or telephone, please tick here:

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Would you be happy for us to contact you about sharing your story on social media and in PR? *

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By signing up to this virtual event I agree to the following T&Cs: 

1. I / we accept that by signing up to this virtual event I / we are consenting to receiving ALL information about this event, including a fundraising pack and sponsorship forms. I / we accept the responsibility of informing Birmingham Hospice should I wish not to receive event specific communications.  

2. I / we confirm that I am sufficiently fit and healthy to take part in this virtual event. Should this change, I / we will seek medical advice. I / we accept full responsibility for ourselves whilst participating in this virtual event and understand that Birmingham Hospice cannot accept liability for any loss or damage to personal property, injury or death. 

3. I/ we take full responsibility for any costs attributed to our participation in this virtual event and will not deduct any expenditure from funds raised. I / we accept the responsibility to ensure that all fundraising monies/donations received in connection with this event are paid to Birmingham Hospice either online or in person. 

4. I / we accept that should I / we no longer be able to take part in this virtual event, I / we will be unable to claim a refund for my registration fee. Any sponsorship collected will be refunded to the donor or gifted to Birmingham Hospice on instruction.

I have read and understand the Terms & Conditions *

Medal Mission: The Best of Brum Challenge

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My Mission

Keeping in Touch

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