Tickets Ticket type Price Amount Adult/Young person aged 14 or over- please complete your details on this page and the details for the person taking part on the next page £50.00 Your details Your name First name Last name Address Address line 1 Address line 2 Town Postcode Contact Phone number Email Keeping in touch We’d love to keep you updated about out work and how you are making a difference to the people we support. We would like to send you information about our fundraising and events and other ways in which you can help us. We will write to you by post unless you ask us not to. Please tell us if there are other ways you’d like to hear from us. Yes, I am happy to receive emails Yes, I am happy to receive text messages No, I do not wish to be contacted by phone No, please don't send me information by post Event details Bungee Jumpers must be 14 or above. 14 and 15 years old will require a parent or guardian to be present, sign permission and complete a non-standard waiver. Please tick to confirm you agree with this. Raising Sponsorship. Please tick to confirm that you understand that the minimum fundraising pledge is £150. I/we agree that any images taken during the event may be used for publicity purposes. Do you have a special reason for supporting the hospice? How did you hear about this event? Social media Hospice website Banners Letter/Email Poster Press Through a friend Next