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Date: ……………………………………………......\u003Cbr>For a participant under the age of 18 to take part in this event, an adult must give permission by signing the declaration above. If you are an adult signing on behalf of someone under 18, please provide your name and relationship to the young person below\u003Cbr>Name: ………………………………………………………………… Relationship:………………………………………… |\n| --- |\n| PAYMENT (Please tick one)\u003Cbr>􀂆 Cheque – please makes cheques payable to ‘British Heart Foundation’\u003Cbr>􀂆 Credit / Debit card – please complete all details below (postal entry only, please do not email this form with card details completed)\u003Cbr>Cardholder’s name:   Visa 􀂆 Visa Delta 􀂆 Mastercard 􀂆 Maestro 􀂆\u003Cbr>Cardholder’s address: (The address the card is registered to)  \u003Cbr>  Postcode:  \u003Cbr>Card No:  Valid from:  /  Expiry date:  / \u003Cbr>Issue No. (Maestro only)    Total £:   |\n\n\n| MORE ABOUT YOU\u003Cbr>Please tell us your reasons for taking part:\u003Cbr>(Please tick all that apply)\u003Cbr>􀂆 I think it will be an enjoyable experience\u003Cbr>􀂆 I want to improve my fitness\u003Cbr>􀂆 Someone asked me to take part with them\u003Cbr>􀂆 This event is easy/convenient for me to get to\u003Cbr>􀂆 I want to do something new/different\u003Cbr>􀂆 This activity is a hobby of mine\u003Cbr>􀂆 I want to raise funds for the BHF’s work\u003Cbr>Please select the statement(s) that apply to you:\u003Cbr>􀂆 I have been affected by a heart or circulatory condition\u003Cbr>􀂆 I am raising money in memory of someone\u003Cbr>􀂆 A family member/friend has been affected by a heart condition\u003Cbr>􀂆 None of the above\u003Cbr>How did you hear about this event?\u003Cbr>(Please tick all that apply)\u003Cbr>􀂆 Poster / leaflet 􀂆 Facebook |  |\n| --- | --- |\n| 􀂆 Email\u003Cbr>􀂆 Newspaper\u003Cbr>􀂆 Radio\u003Cbr>􀂆 Word of mouth\u003Cbr>􀂆 BHF website | 􀂆 Postal mailing from the BHF\u003Cbr>􀂆 Magazine\u003Cbr>􀂆 Google search\u003Cbr>􀂆 Twitter\u003Cbr>􀂆 A website |\n| 􀂆 My local fundraising manager\u003Cbr>􀂆 Other\u003Cbr>Other:    |  |\n\nJOIN THE FIGHT  \nHear about our latest research, campaigns and how you can support our life saving work.  \n􀂆 Yes please, I’d like to hear from you by email  \n􀂆 Yes please, I’d like to hear from you by text message  \n􀂆 No thank you, I don’t want to hear from you by post  \n􀂆 No thank you, I don’t want to hear from you by telephone  \nWe will never share your details with anyone else and will keep them safe. You can change the way you hear from us [at any time by emailing](at any time by emailing supporterservices@bhf.org.uk or)[ ](at any time by emailing supporterservices@bhf.org.uk or)[supporterservices@bhf.org.uk](at any time by emailing supporterservices@bhf.org.uk or)[ or](at any time by emailing supporterservices@bhf.org.uk or)[ ](at any time by emailing supporterservices@bhf.org.uk or)[calling 0300 330 3322](calling 0300 330 3322) .  \n[Find out more in our Pr","cbCaisKVUNVKmsS4","https://ap.wps.com/l/cbCaisKVUNVKmsS4","pdf",161822,"English","# ABOUT YOU\n## YOUR REGISTRATION\n## PAYMENT\n# MORE ABOUT YOU\n# JOIN THE FIGHT\n# TERMS AND CONDITIONS\n# GIFT AID STATEMENT\n# FIGHT FOR EVERY HEARTBEAT","[{\"question\":\"What information does the form ask for under “About you”?\",\"answer\":\"It requests first name, last name, home address, postcode, date of birth, email, main contact number, next of kin name and contact number, and best contact number during the event. It also includes team and company details if applicable.\"},{\"question\":\"How can a participant pay the entry fee and where are the card details shown?\",\"answer\":\"The participant can tick cheque or credit/debit card. For postal entry, card details are collected in the payment section, including cardholder name, address, postcode, card number, valid from/expiry date, and Maestro issue number (if applicable).\"},{\"question\":\"What is Gift Aid and how is the declaration used on this form?\",\"answer\":\"The form includes an option to make and Gift Aid donations to British Heart Foundation. The participant confirms they are a UK taxpayer and understands responsibility for any tax shortfall, and a signed declaration acknowledges the terms and conditions.\"}]","Event Registration Form - Sign up for York Chase the Pud 2016 - Please complete one form per participant | PDF",1789843773]