Polar Plunge

How many people would you like to register for the Polar Plunge? The cost will be £10 per person

We need a few details to register you:

Your first name

Your last name

Email address type

Your email address

Your email address

Your email address

Your email address

Address line 1

Address line 2

Town/city

Postcode

I confirm that I am over 17

Yes

Please provide the following details for all additional participants:

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

First name

Last name

I confirm this participant is over 17

Yes

Please enter your card details to pay your registration fee

Card Number

Cardholder's full name

Cardholder's email address

Expiry Month

Expiry Year

CVV

How did you hear about the Polar Plunge?

Please specify

Do you want to stay in touch?

We send a monthly e-newsletter along with occasional updates on our news, fundraising, events, merchandise and volunteering - please tick the box to receive these updates. If you don't opt in, we will only contact you with information specifically relating to this event.

Yes, I'd like to receive updatesPlease only contact me with information specifically relating to this event.

How would you like to hear from us?

Email

Yes pleaseNo thanks

Post

Yes pleaseNo thanks

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