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The BUPA Great North Run Application Form


I would like to join Roy’s runners for The BUPA Great North Run on Sunday 5th October 2008
I have my own place in the Great North Run and wish to run for The Foundation. Please send me a fundraising pack.
I would like to apply for one of The Foundation’s golden bond places. (Minimum amount to be confirmed Aug/Sept of 2008)
Personal Details:
Name:  
Address: Telephone:
Mobile:
Email:
If you would like to offer more information, please feel free to do so in the box provided:
Have you been affected by lung cancer?

How much are you aiming to raise?

£

The Roy Castle Lung Cancer Foundation will use your information for administration and analysis. We may share your information with other companies or carefully selected third parties. Such parties may contact you or send you details relating to other goods and services which might be of interest to you. If you do not wish to be shared with carefully selected third parties, please tick this box.