Sleep Easy Sign Up Form Question Title * 1. Will you be attending Sleep Easy at The University of Surrey? Yes No Question Title * 2. Contact Information Name * Organisation (If sleeping out as part of a team) Address * Address 2 City/Town * State/Province * ZIP/Postal Code * Country * Email Address * Phone Number * Question Title * 3. Emergency Contact Details (In case of emergency or accident on the night please give name and phone number of someone we can contact) Question Title * 4. Fundraising GoalWe ask all participants to raise sponsorship to help end youth homelessness via https://www.justgiving.com/campaigns/charity/ymcadownslinkgroup/sleepeasy2017 (Please tell us how much you plan to raise) Question Title * 5. Why are you getting involved in Sleep Easy?(This may be used for publicity purposes) Question Title * 6. How did you hear about sleep easy? Question Title * 7. Disclaimer I confirm that I will be 18 or over on 24th March 2017 I confirm that I am physically fit enough to sleep outside and that the organisers will in no way be held responsible for any injury, loss or illness incurred to my person as a result of this event I give my consent for photos of me to be taken and used for publicity Submit response >>