Banger Rally Challenge 2022 Request a free charity place If you would like a free charity place for this event please complete your details below and we will send you an application form. Your contact details Please can you give us your full details and complete all fields marked with * Title * - Select -MrMrsMsMissDrProfRev First name * Last name * Email Daytime tel Address line 1 * Address line 2 Address line 3 Town/City County Postcode * Your contact preferences Children’s Hospice South West would like to keep you updated with news about our hospices, fundraising activities and campaigns and other ways you can help make a difference to short and precious lives. Please let us know below how you would like us to contact you. If you change your mind in the future, you can opt out at any time. I confirm I am over 18: * Yes No Please confirm if you are happy for us to contact you by: post: Yes No phone: Yes No email: Yes No Contact preferences Your privacy We take your privacy seriously. We will store your details securely on our database(s) and we will only use your personal information to provide the services you have requested from us. We will never share your details with third parties for marketing purposes without your prior explicit consent. For more information, please see our Privacy Policy or call 01271 325 270. Leave this field blank Request charity place
