Walk for Wildlife 2012 Registration Form

Please complete in full and tick boxes where appropriate. Online & postal payment options are given on the next page, once you have submitted this registration form.

Enter not this field:

Your Details

Name:*
Address:*
Telephone:*
Email:*

Length of Walk

I/we wish to enter the:

Type of Registration (the fees rise after the 31st August)

Adult(s) £12:
	Over 16 years old.

No. of Adults?:*

Children £3:
	Under 16 years old. Must be accompanied on the walk by an adult.

No. of Children?:

Family £25:
	This includes 2 adults & up to 2 children.

No. of Adults & Children?:

Payment Type

How Will You Be Paying for Registration?:

*Indicates a field you must enter.

Disclaimer: Dorset Wildlife Trust and associated companies cannot accept any responsibility for death, injuries, accidents or property damage caused by taking part in this event. All information is provided in good faith. You should consult your doctor before embarking on any programme of physical activity or any event you are unsure of. By completing and submitting this form you are confirming that you believe you are physically able to undertake this walk and will not hold the organisers liable for any accident, loss or damage. You also acknowledge that you have read and understood this information. You will be covered by third party insurance but should you wish to take your own for personal injury we can offer you advice.

PLEASE READ: When you have completed this form, please click the Send Details button ONCE to send. You will then be given the choice of paying your registration fee online by credit card, by telephone or by post (cheque).


	Registered in England as: The Dorset Trust for Nature Conservation Ltd. Registered Company No. 68843 Registered Charity No. 200222 Copyright © 2011 Dorset Wildlife Trust \| Site Map