Register for Liverpool Marathon 2012

Thank you for your interest in joining the Stroke Association's team for the Liverpool Marathon 2012.

If you are applying for a charity place there is a minimum sponsorship target of £450. If you already have your own place in the event there is no set sponsorship target so the sky's the limit!

If you have any questions about the event or about the work of the Stroke Association then get in touch by sending us an email or giving us a call on 0161 742 7484.

How would you like to join our team? *

I have my own place in the event and would like to fundraise for the Stroke Association

I would like to apply for a charity place in the event and pledge to raise £450 in sponsorship

Your Personal details

Title *

First name *

Last name *

Date of birth

Gender *

Please indicate what size running vest you require *

We would like to send you some iron-on letters with your running vest. Please let us know which letters you would like to receive (e.g. your first name or a nickname) *

Contact details

Address 1 *

Address 2

Town

County *

Postcode *

Email *

We are committed to protecting the environment, therefore where possible all information will be available to download. Please select 'yes' if you are happy to download, or 'no' if you would prefer items by post

Contact phone number *

Your Running History

Have you run a marathon before? *

If 'Yes' what was your finishing time?

How long do you think it will take you to complete the Liverpool Marathon? *

Please give the answer in the following format HH:MM:SS

Are you affiliated to a UK Athletic / Running Club? *

If yes please state which

Have you / will you have applied for a place through the official marathon ballot? *

Have you applied for other charity bonded places? *

Your Story

Why do you want to run for The Stroke Association? *

Are you doing this event in memory of someone? *

If you would like to give us their name, please do so here

Would you be happy to be contacted by our press officer? *

Yes

No

If you know anybody who may also like to run the Liverpool Marathon for The Stroke Association, please provide their details and we’ll get in touch.

Fundraising

Most charities offer their marathon places to those who can raise a minimum of £450.00. How much sponsorship money do you realistically believe you will be able to raise for the Stroke Association? *

Please Note: If you already have your own place in the Liverpool Marathon you will have no set sponsorship target. The £450 target is for those applying for one of the Stroke Association's charity places.

Please detail how you intend to reach your sponsorship target *

Contact

How did you hear about this event?

If 'Other' please specify

The Stroke Association would like to keep you informed about the work we are helping to make possible. Please choose 'Yes' if you are happy for us to contact you. *

Yes

No

We will sometimes allow other organisations whose aims are in sympathy with our own to contact you. *

Yes

No

Are you happy for us to send you information about The Stroke Association's work by email? *

Yes

No

Terms and conditions

If I have applied for a charity place and am allocated a 2012 Liverpool Marathon bonded place I pledge to raise the sponsorship amount detailed in section 3 for The Stroke Association. If I have stipulated on the application form that I have my own place purchased from the race organisers, I confirm this by accepting the terms and conditions. Participants permit the Stroke Association to use any photographs taken during or after the race for any advertising or editorial purposes including on the World Wide Web. I will abide by all rules stated and will take full responsibility for my actions on event day.

I agree *

I agree

I don't agree

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Register for Liverpool Marathon 2012