If you are prepared to commit yourself by registering, please complete details below.
Name:
Address:
Post Code:
Home Phone Number:
Work Phone Number:
Mobile Phone Number:
Email:
Walk Option:
Long walk
Short walk
Age Group:
Under 18
18-40
40-60
60+
I would be interested in purchasing a t-shirt, if available
I pledge all my sponsorship money collected will be given to ORBS. I understand that the organisers of this race cannot be held responsible for any injury or loss sustained by me. I enter this walk at my own risk.
