Question Title

* 1. Your Name:

Question Title

* 2. Your address:

Question Title

* 3. Your contact number:

Question Title

* 4. Your email address:

Question Title

* 5. Your occupation:

Question Title

* 6. Your date of birth:

Question Title

* 7. Have you committed to doing any fundraising for a charity before? If yes please detail below.

Question Title

* 8. How much running are you currently doing?

Question Title

* 9. Have you previously run a Marathon? If yes please detail below including times.

Question Title

* 10. What is your connection to the Limbless Association? If none where did you hear about us?

Question Title

* 11. Why do you want to run for the LA in the London Marathon?

Question Title

* 12. Our runners have been given a target of £2,500 for their fundraising. If a place was to come available by 1st January do you think that target is realistic for you? If not please advise how much fundraising you believe you could commit to.

Question Title

* 13. If successful are you happy for us to promote your training and fundraising?

Question Title

* 14. Would you like to be added to our email mailing list to be kept up to date with the charity, our services, fundraising news and opportunities?

T