Stroke for Stroke supported by Siemens - Register for Stroke for Stroke

Register for Stroke for Stroke

* Required information

Crew name

Crew name (You can still register as an individual: just use your own name as your crew name) *

Crew details

Crew members (min 1, max 8) *

Crew region (UK only) *

Crew password *

Confirm Crew password *

Crew pledges (n.b. you can edit these later on the 'My Crew' page)

How far will the crew row in total(min 10KM each)*

How much the crew aims to raise (£) *

Crew leader details (this is the primary point of contact)

Name *

Email *

I would like to receive SfS updates by email

Phone number *

Date of birth

Address line 1 *

Address line 2

Address line 3

Address line 4

Postcode *

Nuffield Health & Stroke for Stroke

Stroke for Stroke have teamed up with Nuffield Health & Wellbeing Centres to help support your team to complete for the Stroke for Stroke 10km challenge.

If you are already a member of Nuffield Health please indicate below:

I am an existing Nuffield Gym member

If you are not a member and would like to request a complimentary gym pass please indicate below:

I would like receive a 5 day pass to a Nuffield Health Fitness & Wellbeing Centre and confirm I am happy for my details to be passed onto Nuffield Health.

Crew members (enter all additional team members here)

Crew member 2

Name

Crew member 3

Name

Crew member 4

Name

Crew member 5

Name

Crew member 6

Name

Crew member 7

Name

Crew member 8

Name

Stroke for Stroke 25th - 31st January -sponsored by Siemens

Siemens Stroke for Stroke

Register for Stroke for Stroke

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