My Details


My Address

Fundraising Pledge

Please include here the amount you are pledging to raise for Rowcroft. The minimum amount for the Fire Walk is 100 GBP and for the LEGO walk it is 60 GBP:


Reason for Taking Part

Participant's Medical Information

Emergency Contact

Please note: This must be someone who is not participating in the event.

Keeping In Touch

We'd love to keep in touch with you to share our news on the progress we are making or how you can support our work. We would like to occasionally contact you via email. Please let us know if you would like to receive the following:

Participant Terms and Conditions

I have read and understand the Terms & Conditions *