Sunday 31^st July 2022

We need the brave and the bold to take the plunge for St Andrew’s Hospice.

You will be lifted 160ft above our car park in a specialised crane before taking one giant leap for the Hospice.

Participants must be aged 14 or over. Participants aged 14 and 15 require a parent on guardian’s permission and signature.

Registration fee: £25
Minimum Sponsorship: £200

Important: Please read this Health Warning Notice before registering

Name *

First

Last

Address *

Address Line 2

Town / City *

County

Postcode *

Country

Phone *

Email *

Date of Birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

T-shirt size: *

• Small
• Medium
• Large
• X-Large

Terms & Conditions *

• I have read the Health Warning Notice and agree to the terms and conditions of this event which have been provided on the event webpage.

Bungee Jump 2022 Registration Fee:

Price: £ 25.00

Total

£ 0.00

Stripe Credit Card *

Card

Name on Card

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

• Post
• E-mail
• Telephone
• No Contact

We really value your support and would like to stay in touch to keep you up to date on the work of St Andrew's Hospice including our events and fundraising activity. We will never sell or share information with other charities or organisations for marketing purposes not related to St Andrew's Hospice.

Submit