Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I will be arranging my own sponsored event, and therefore will notify the charity once its completed and funds are collected. Please send me my “Walk this May” Bib. *

Yes

No

I will be joining the Founders and the team on the 10k walk and have read the information on this website. Please send me my “Walk this May” Bib. *

Yes

No

Declaration *

By ticking the box below I understand and agree that I am undertaking this event at my own risk and that Zebras Children and Adults Charity is not responsible for any risk, injury or loss that may result, and will not be liable for any claim which may arise from this event.

I Agree