Gelt Gladiator Payment Form - Eden Valley Hospice

Gelt Gladiator Payment Form 2026

Name(Required)

First Last

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City County Postcode Country

Email(Required)

Phone(Required)

Group name (If you are taking part in a group, please name the lead participant)(Required)

Are there any medical conditions we should be aware of? If so, please specify(Required)

You will receive a t shirt to wear on the day, what size would you like?(Required)

This person cannot be yourself and must be contactable on the day.

Full Name(Required)

Emergency Contact Phone(Required)

How did you hear about Gelt Gladiator?(Required)

Please tick below if you would like to be kept informed of hospice news, events and appeals by email. Select the categories you wish.

To unsubscribe at any time, please contact communications@edenvalleyhospice.org or call 01228 810801.

Hospice news

How to support the hospice

Lottery/raffle updates

I agree to raise the minimum sponsorship amount of £50.(Required)

I agree

I understand that this is a public event and images/videos will be taken by the hospice for promotional use.(Required)

If you have any problems with photography permissions, please email communications@edenvalleyhospice.org

I understand

Registration fee

Price:

Credit Card