Conquer the Rainbow form - Rainbow Trust Children's Charity

Your details

Your team name *

First name *

Last name *

Email address * Your date of birth *

Day:

Month:

Year:

Your mobile number *

Start typing your address or postcode *

Or enter your address manually.

Address line 1 * Address line 2

Town / City *

County

Postcode * Country *

Are you a corporate partner of Rainbow Trust? *

Medical conditions, allergies and dietary requirements

Do you have any pre-existing medical conditions? If so, please provide details and any current medication you are taking Do you have any allergies? If so, please provide further details. Do you have any special dietary requirements? If so, please can you list your dietary requirements below.

Emergency contact details

Emergency contact name * Emergency contact number * Emergency contact relationship *

Clothing

Would you like a tech t-shirt? *

You can view our tech t-shirt.

If so, let us know your t-shirt size

You can view the size chart here (PDF).

Would you like Rainbow Hair? *

Tell us about why you're supporting us

Why are you supporting Rainbow Trust? * How did you hear about this? *

Your contact preferences

I am happy to receive emails from Rainbow Trust *

We would love to stay in touch to show you how your fundraising is helping, with news and information on how you can be involved with our vital work.

Yes

Are you sure? If you click 'no' we won't be able to tell you about our work. You can unsubscribe whenever you like.

I am happy to receive calls from Rainbow Trust *

Yes

Please leave this field blank