Use the form below to sign up the Big Walk.

Places are limited — so grab your spot today! 

The information you provide on this form, including medical information, will be held by Lancaster Diocese Youth Service for the purpose of organising this event and will not be used for any other purpose, or shared with any other organisation, without your consent, excpet in the case of mediacl emergency.

PLEASE NOTE: YOUR PLACE IS NOT CONFIRMED UNTIL A DEPOSIT HAS BEEN RECEIVED

Personal Details
Name *
Name
House name/number, Street, Town, Postcod
Gender *
Please let us know of any special dietary requirements you have.
T-Shirt Size *
Medical Information
List all medical conditions.
Please list any medication you take.
Emergency Contacts
Emergency Contact 1 *
Emergency Contact 1
How are they related to you?
House name/number, street, town, postcode
Emergency Contact 2 *
Emergency Contact 2
How are they related to you?
House name/number, street, town, postcode
Personal Agreement
Photo Policy and Guidelines *
You are joining the Youth Service on this trip and are expected to abide by the guidelines and rules given. By checking the box below you confirm your agreement to the terms and conditions, photo policy and guidelines set out on the website.
Happy to receive news? *
We won't use your information without your permission. Would you like us to send information bout other events that are happening?
Parental Consent (for under 18s)
Parental Consent (if under 18)
I have read the terms and conditions of this event and confirm I wish my son/daughter to attend.
Parent's Name
Parent's Name