Ben Nevis Challenge 2025

Your Name *

First

Last

Your Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Your Date of Birth *

Your Phone Number *

Your E-mail Address *

Your Emergency Contact's Name *

First

Last

Your Emergency Contact's Phone Number *

Please provide details of any medical condition/allergies which our first aiders should know about should you require first aid: *

If none, please write Not Applicable in the box

Do you have any special dietary needs? *

Please note: It may not be possible to cater for all special dietary needs.

If yes, please give details:

Do you have a preference as to whom you share a room with? *

If yes, please tell us who you would like to share a room with:

Room Type Preference

Every effort will be made to accommodate personal preference.

If using the transport provided by the Hospice, please indicate which pick-up point would be most convenient for you: *

Ben Nevis Challenge Registration Fee

Price: £25.00

Total

£0.00

Your Card Details *

Card

Name on Card

Please tell us how you heard about this event: *

If 'Other', please tell us how you heard about this event:

Please select the ways we can keep in touch with you: *