Shine London 2019 Registration Page

Welcome to the Shine London registration page.

Please complete the simple form below for all walkers.

If you have any queries please do contact us.

Go Shiners!

Title*
First Name*
Last Name*
Date of Birth*
Hidden
Address Line 1
Hidden
Address Line 2
Hidden
Town / City
Hidden
Postcode
Contact Telephone Number*
Email Address*
Enter Email Confirm Email
Hidden
Cancer Type to Raise Money For
Hidden
SHINE Location
Hidden
Shine Start Times
Hidden
Distance
Unisex T-Shirt Size*
Please note when choosing your t-shirt size that they are a snug fit and most people wear them over a long sleeved top with it being a September evening.
Hidden
Minimum Fundraising Pledge
Emergency Contact Name*
Emergency Contact Telephone Number*
Coach Share*
Coach Pick Up Stop i.e. Reading, Brentford etc
Comments
This field is for validation purposes and should be left unchanged.

0 Shares