Santa Dash - Sign up - Trinity Hospice

Unique ID
Blackpool Santa Dash

Sunday 1st December 2024

Adults (16+): £12.00
Child (15 and under): £6.00
Family ticket: £30.00

Please note that in order to complete this form you will need to know each person's full name and date of birth. You'll be required to enter this information at Step 5.

Your Details
Your online reference number (if you have one)

Title*
Other*

First Name*

Last Name*

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address (Enter Email)*
Enter Email Confirm Email

Mobile/Telephone*

How did you hear about this event?*

Keeping in Touch
We’d love to keep you updated on how your support is making a real difference to our patients and we may contact you by post or telephone to let you know about our services and other ways you can get involved, including Blackpool Santa Dash. Please let us know if you are happy to hear from us by email and text.
Keep in Touch (Email)
Yes, I'd like to hear from you by email
Keep in touch (Phone & SMS)
Yes, I'd like to hear from you by text message
We promise never to sell your data. Please read our Privacy Policy for more information about how we use and protect your data.

Sponsorship and Donations

Brian House provides specialist, expert care to children living with life-limiting conditions, as well as vital support for their family.

Brian House is the only children's hospice on the Fylde coast and whilst care is completely free of charge to those who need it, it costs over £1.4million a year to run our services. By making a donation today or pledging to raise sponsorship, you’ll be helping us to keep our doors open for many years to come.
I would like to...
Raise sponsorship
Make a one-off donation
Sponsorship
Sponsorship

I will be raising sponsorship as an individual

I will be raising sponsorship as part of a team
I/we pledge to raise:*
Make a Donation
Thank you for choosing to make a donation. If at a later date you decide that you would also like to raise sponsorship, you can easily set up a JustGiving page.
Donation amount*

5.00

10.00

25.00

30.00

£50.00

Other – type amount
I would like to make a donation of:*
Please enter your own amount

Subtotal
£ 0.00
Would you like to Gift Aid your additional donation?

For every £1 that you donate, we can collect 25p from the taxman

I want to claim Gift Aid on my donations, any donations I have made in the last 4 years and any I make in the future to Trinity Hospice & Palliative Care Services. I am a UK tax payer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.
Gift Aid option*

Yes, I would like to add GiftAid to my donation

No, do not add Gift Aid

If you are booking a team please provide a team name

Participant Details
Please add the details of ALL the participants you are registering for this event, including yourself if you are taking part.
Family Member - Adult

Family Member Adult - Title Family Member Adult - First Name Family Member Adult - Last Name Family Member Adult - Date of birth Actions

There are no Entries.

Maximum number of entries reached.

Family Member - Child

Family Member Child - Title Family Member Child - First Name Family Member Child - Last Name Family Member Child - Date of birth Actions

There are no Entries.

Maximum number of entries reached.

Participant Details 2
Please add the details of each participant you are registering, including yourself if you are taking part.
Family Member 2 - Adult

Adult - Title Adult - First Name Adult - Last Name Adult - Date of birth Actions

There are no Entries.

Maximum number of entries reached.

Family Member 2 - Child

Family Member Child - Title Family Member Child - First Name Family Member Child - Last Name Family Member Child - Date of birth Actions

There are no Entries.

Maximum number of entries reached.

Adult - Entry

Adult - Title Adult - First Name Adult - Last Name Adult - Date of birth Actions

There are no Entries.

Maximum number of entries reached.

Child - Entry

Child - Title Child - First Name Child - Last Name Child - Date of birth Actions

There are no Entries.

Maximum number of entries reached.

Declaration*
By submitting this form you are agreeing to the following: 'I/we understand that I/we take part in this event at our own risk and that Trinity Hospice & Palliative Care Services cannot be held responsible for any loss or damage to personal effects, personal accident, injury or any public liability. I/we agree that any images taken during the event may be used for publicity purposes.' You are also agreeing to the Santa Dash terms and conditions.
Total
£ 0.00

Step 1 of 6

Blackpool Santa Dash

Please select the number of tickets you would like

Your Details

Keeping in Touch

Sponsorship and Donations

Sponsorship

Make a Donation

Would you like to Gift Aid your additional donation?

Participant Details

Participant Details 2