If you’re keen to run and raise money for The Brain Charity, please fill in the form below.

Grab your place on the start line today!

Your Name:*
Phone Number:*
E-mail:*

* = Required fields

Date of Birth:
I confirm that I will be 18 or over at the time of the event*
Address:
Why do you want to run for The Brain Charity?
Please tell us about your running experience:
How do you plan to raise the minimum sponsorship pledge of £250?
Name of employer:
Does your employer run a matched giving scheme?
How did you hear about this opportunity?
Keeping in touch - I am happy for The Brain Charity to contact me by:

Don’t worry we will not pass on your details to anyone outside of The Brain Charity.

You can always change the way you wish to hear from us at anytime by emailing us or by calling 0151 298 2999.

Terms and Conditions

1. You confirm that you are not aware of having any medical conditions which would prevent you from taking part in sporting activities.

2. You understand that the minimum sponsorship you need to raise is £250 and that you are personally liable for any shortfall in fundraising.

3. If you are our chosen runner, you agree to pay a non-refundable £50 registration fee to The Brain Charity, inclusive of VAT. This amount does not contribute towards your £250 sponsorship pledge. If, for any reason, you have to cancel your place or injure yourself, you will not receive a refund for monies raised and your registration fee of £50.

4. You understand that you may be contacted by a member of The Brain Charity team with a view to sharing your story at a later date.

5. You give permission for any photos taken of you at this event to be used to help with future promotion of The Brain Charity.

6. If you are unable to participate in the event for any reason all monies donated in support of The Brain Charity must be forwarded to The Brain Charity or returned to the individual donors. Monies already received by The Brain Charity cannot be refunded.

7. If allocated a charity place for The Brain Charity, you must agree to fundraise solely for The Brain Charity.

8. By accepting the place, you agree to adhere to the event organisers own terms and conditions for the event.

I have read, understand and agree to the terms and conditions for this event*