Register as an Individual Walker

To register as a individual walker on Crusaid Walk for Life 2010, please complete the form below.

Interested in setting up a Team?

To setup a team, please register yourself as an individual walker then login to your account. You will then be provided with a facility to setup your team.

Your Personal Details

* please note required fields.
Title :	Mr Mrs Ms Miss Other *
First Name :	*
Last Name :	*
Address :	*
Town / City :	*
County / State :	*
Post / Zip Code :	*
Country :	United Kingdom United States of America - Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Ascension Island Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia & Herzegovina Botswana Brazil British Antarctic Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Congo (Democratic Republic) Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica, Commonwealth of Dominican Republic East Timor (Democratic Republic of) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Fiji Finland France French Caledonia French Guiana French Polynesia Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Grenada Guadeloupe Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, DPR (North Korea) Korea, Republic of (South Korea) Kosovo (UN Administration) Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Palestine National Authority Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Christopher and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa Sao Tome & Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia & Sandwich Islands Spain Sri Lanka St Helena St Pierre & Miquelon Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks & Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis & Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe *
Mobile / Tel :
Email :	*
Confirm Email :	*
Gender :	Male Female *
Date of birth :	(DD/MM/YYYY format) *
Password (6-12 characters) :	*
Confirm password :	*

Setup your sponsorship page

Set your fundraising target £

Tell the world why you're joining Crusaid's Walk for Life:

Add an image to your sponsorship page (optional) :

jpg / gif / png (max 300Kb)

Additional Information

How did you hear about Crusaid's Walk For Life?

Mailing Flyer Postcard Metro Time Out QX The South African Gaydar Weekend Guardian Magazine Local Newspaper PinkPaper.com Poster Radio Word of mouth Facebook Twitter Other If other, please specify:

Have you taken part in Crusaid's Walk For Life before?

yes no

If so, in what year(s) did you walk?

02 03 04 05 06 07 08 09 Other

If other, please specify:

Do you have any special requirements that we should know about?

yes no

If so, please specify your special requirements:

Please note that by registering for the Crusaid Walk For Life you are agreeing to receive mailings and emails in relation to this event.

I am happy to receive additional mailings from Crusaid

I am happy to receive additional emails from Crusaid

This year we are charging a £10 registration fee. However, under 15s and unwaged (unemployed, oaps, and students)walkers are free. Please note that you will be asked to provide proof of your status upon registration on the day of the walk. Please select your status below:

Over 15 / Employed - £10 Registration Fee Under 15 - Free of charge Unwaged - Free of charge

I accept the Terms and Conditions of participation in the event