Charity sign up form Join #TeamROH today! Thank you for interest in running with #TeamROH. Please sign up to our team by following the below instructions: - Create a just giving page and link this to The Royal Orthopaedic Hospital Charitable fund. www.justgiving.com/roh - Fill out the below sign up form! A member of the fundraising team will be in touch to get you started on your journey as a #TeamROH runner. OK Question Title * 1. What planned event would you like to take part in:If you would like to sign up to fundraise for us and the event is not listed below, please email roh.charitablefunds@nhs.net rather than completing this form. Birmingham Half Marathon 2020, Sunday 11 October.By completing this application form you are agreeing to raise at least £200 for the charity for each adult signed up. All processing fees will be done by the hospital (we'll sign you up) Birmingham 10k, Sunday 31 May 2020By completing this application form you are agreeing to raise at least £150 for the charity for each adult signed up. All processing fees will be done by the hospital (we'll sign you up) 5k Tough Mudder, June 13th 2020By completing this application form you are agreeing to raise at least £100 for the charity for each adult signed up. All processing fees will be done by the hospital (we'll sign you up) Birmingham Velo (100 miles), 21st June 2020By completing this application form you are agreeing to raise at least £400 for the charity for each adult signed up. All processing fees will be done by the hospital (we'll sign you up) Other (please specify) OK Question Title * 2. Full name OK Question Title * 3. Home address and postcode OK Question Title * 4. Email address OK Question Title * 5. Telephone OK Question Title * 6. What is your preferred method of contact? Email Telephone Post OK Question Title * 7. Date of birth OK Question Title * 8. Next of kin (Name & contact details) OK Question Title * 9. I have signed up to our Justgiving page: www.justgiving.com/roh Yes No Other (please specify) OK Question Title * 10. What Charity T-Shirt size would you like? Small Medium Large Extra Large Extra XLarge Other (please specify) OK Question Title * 11. Have you taken part in any other fundraising activities for The Royal Orthopaedic Hospital No Yes (please specify) OK Question Title * 12. How did you hear about us? Social Media A member of staff Website Promotion within the hospital Other (please specify) OK Question Title * 13. I would like to be kept in touch with future fundraising events & News Yes (via email) Yes (via post) No OK Question Title * 14. Would you be willing to be a team captain for your chosen event? (this would mean sharing your contact details with other fundraisers in the team) Yes No OK Question Title * 15. Would you be willing for your contact details to be shared with the team captain? Yes No OK Question Title * 16. Please confirm below that you are aware of and agree for the hospital to sign you up for this chosen event & incur the costs for this. In return we ask that you raise an agreed amount for the hospital charity. (please refer back to question 1 or the event posters, to confirm this amount) I agree OK Thank you for signing up! We'll be in touch to send details of the day and if not already, how to join our justgiving teams.Look out in your emails for materials in order to make fundraising for you as easy as possible! OK COMPLETE
