Firewalk registration form

Welcome to the registration form for the Deafblind UK Firewalk, taking place at Peterborough Cathedral on 21st March 2025. The following form can be completed for up to two participants per submission.

Early bird entry is available until 31st January 2025. Standard entry is available thereafter until 14th March 2025.

Your Details

Deafblind UK Firewalk entry - Early Bird

Price:

Title(Required)

Please tell us your title(Required)

First name(Required)

Surname(Required)

Date of birth(Required)

Note: You must be at least 16 years of age to participate in the Firewalk and under 18s must be accompanied by a participating adult and supervised at all times.

Gender(Required)

Address(Required)

Street Address Address Line 2 City County Post Code Country

Phone(Required)

Email address(Required)

Enter Email Confirm Email

Must be checked regularly (this is the most effective way for us to communicate with you)

By submitting this form, you consent to be contacted by email for the purpose of this event. If you would like to receive emails about other exciting ways to support Deafblind UK, or with news about our work, please tick the box below.

I am happy to receive emails where possible

You can update your contact preferences at any time by calling 0800 132320, by email to [email protected], or by clicking ‘unsubscribe’ at the bottom of our emails. For more information on how we use your data please see our privacy policy.

About your participation

Do you have a condition or disability which we should be aware of for accessibility purposes?

E.g., I am sight impaired

Yes

Name of condition or disability(Required)

Emergency contact name(Required)

Emergency contact number(Required)

Are you taking part in memory of a loved one? (If yes, please provide their full name and relationship to you)

e.g., John Smith (father)

Where did you hear about the Firewalk event?(Required)

Would you like to register a second person?

Yes

Details of participant 2

Deafblind UK Firewalk entry - Early Bird - Participant 2

Price:

Title(Required)

Please tell us their title(Required)

First name(Required)

Surname(Required)

Date of birth(Required)

Note: You must be at least 16 years of age to participate in the Firewalk and under 18s must be accompanied by a participating adult and supervised at all times.

Gender(Required)

Address of participant 2(Required)

Same as first participant

Street Address Address Line 2 City County Post Code Country

Phone - participant 2(Required)

Email address - participant 2(Required)

Enter Email Confirm Email

Must be checked regularly (this is the most effective way for us to communicate with you)

Does participant 2 have a condition or disability which we should be aware of for accessibility purposes?

E.g., sight impaired

Yes

Name of condition or disability(Required)

Emergency contact name(Required)

Emergency contact number(Required)

Is Participant 2 taking part in memory of a loved one? (If yes, please provide their full name and relationship to participant 2)

e.g., John Smith (father)

Would you like to make a donation with your entry?

Please enter your donation amount(Required)

You could increase your donation by 25% at no cost to you

I want to Gift Aid donations I make now and any donations I make in the future or have made in the past 4 years to Deafblind UK. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

Total

Disclaimer(Required)

I understand that I take part in the event at my own risk and that the organisers will not be liable for any injury, or illness, except where injury, or illness, is caused by their negligence and they are legally liable. I confirm that all the information provided by me in this form is, to the best of my knowledge, true and correct, and that providing false information may affect my participation. I agree to abide by any terms and conditions of the event as agreed by the organisers and that fellow participants aged under 18 will be supervised by an adult at all times. I undertake at all times to behave responsibly. I agree to follow any and all safety instructions given by the organisers before and during the event. I confirm that I will endeavour to raise at least £100 in sponsorship for Deafblind UK through my participation in this event. By taking part in the event, I agree to Deafblind UK and their volunteer photographers using my name and any footage or photographs taken during my participation to be used in any future promotional material. (Please tick to indicate that you have read and agree to the disclaimer).

Phone

This field is for validation purposes and should be left unchanged.