Register for your local Step Out 2012

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The entry fee for this event is £5, which covers the cost of the event and a Step out T-shirt which will be given to you on the day. This cost is unfortunately non-refundable and non-transferable.

Stroke is the UK's third biggest killer and leading cause of disability amongst adults. Your entry fee does not include a donation, 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.

Which event would you like to take part in? *

Grosvenor Park, Chester

Ponty Park, Pontypridd

Canford Park, Bristol

Sanders Park, Bromsgrove

Your Personal Details

First Name *

Last Name *

Contact details

Address 1 *

Address 2

Town *

Country

Postcode *

Email *

Contact phone number *

Gender *

Date of birth

T-shirt size *

Small

Medium

Large

Extra Large

Fundraising for the Stroke Association

Fundraising *

How much are you aiming to raise for the Stroke Association?
This is only a target and will not be charged as part of your entry fee. It assists us in planning how we can support the 150,000 people affected by stroke each year.

Do you have a link to stroke? *

Yes

No

Are you doing this event in memory of someone? *

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

Emergency Contact

Emergency Contact Name *

Emergency Contact telephone number *

Terms and Conditions

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

I agree *

I don't agree

I agree

Contact

How did you hear about this event? *

If 'Other' please state

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

Volunteers *

Yes

No

Volunteers play a crucial role in our work and in delivering the National Events calendar. Please select 'Yes' if you are happy for us to contact you about volunteering opportunities.

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

Yes

No

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

Need to talk?

Help us to take action on stroke

Register for your local Step Out 2012