Register for Vertigo Challenge

Print page

The entry fee for this event is £10. This cost is unfortunately non-refundable and non-transferable. All participants must pledge to raise a minimum of £50 in sponsorship.

The minimum age for this event is seven but all participants under the age of 18 must have the consent of a parent/guardian and be accompanied by an adult at all times.

Stroke is the UK's third biggest killer and leading cause of disability amongst adults so every pound you raise in sponsorship helps us to work towards a future with fewer strokes, where all those affected get the help they need.

By registering online you are agreeing to our terms and conditions.

When would you like to do your jump? *

Your Personal details

Title

First name (as per your passport) *

Middle name(s) (as per your passport)

Last name (as per your passport) *

Gender *

Address

Address 1 *

Address 2

Town

County *

Postcode *

Date of Birth *

Email *

Phone number *

Employer

Are you doing this event in memory of someone? *

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

Next of kin details

Next of kin name *

Relationship to you *

eg. your mother or father

Next of kin contact number *

Please list your allergies or any medicines you are taking

Contact

How did you hear about this event?

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

I have read and understood the terms and conditions. I agree to raise the minimum sponsorship of £50. I have read and agree to the terms and conditions. I will abide by all rules stated and will take full responsibility for my actions on event day.

I agree *

I agree

Need to talk?

Help us to take action on stroke

Register for Vertigo Challenge