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* Your name

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* Email address (if you'd prefer we contact you by post, enter your address below)

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* Phone number

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* Post address (if you'd prefer we contact you by email you can leave this blank)

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* Team name - if you are joining an exisiting team, or starting a new one, please let us know the team name if you have one

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* Please tell us a bit about why you'd like to take part in Walk with M.E. and fundraise for Action for M.E.

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* Sharing your story helps us promote your fundraising and raise awareness of M.E. Would you be happy for us to share your story?

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* We will contact you about Walk with M.E. in 2020. We'd love to also keep you updated about the work you're helping to fund, our research and services. Please say below how you'd like us to contact

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