Apply to run Virgin London Marathon for St John Ambulance

London Marathon 2012 logo

Thank you for registering your interest in supporting St John Ambulance through a Charity/Golden Bond place for the Virgin London Marathon 2013.

Please complete all the details in the form below and answer the questions as thoroughly as you can. We use this information to make decisions about our places.

If accepted on to the St John Ambulance team we will contact you in the next few days to discuss your application. We will only take the £100 payment if you are successful in getting a place.

We also require all runners to have raised £825 by Monday 1 April 2013, £1150 by Monday 6 May 2013 and full sponsorship fee by 3 June 2013.

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If you have any further questions about the application process or the associated terms and conditions, please contact the Events team at events@nhq.sja.org.uk or call 020 7324 4173.

Any information submitted will be confidential.

Data protection statement

Your data will be handled in accordance with the Data Protection Act 1998 and will be used by us in connection with your registration and to keep you informed about our activities, events and services. We will use your information to send you newsletters, information and updates for other fundraising purposes. We may send offers and information by mail, email and telephone. We will not share your information with any third party organisations except where we are required to do so by law or where we have a contract in place for the lawful processing of data. You have a right under the Data Protection Act 1998 to obtain information from us. If you have any queries concerning this right or no longer wish to receive information about our other activities, please contact our Data Protection Officer at St Johns Gate, London EC1M 4DA.

Terms and Conditions

St John Ambulance requires all Virgin London Marathon runners to agree to our Terms and Conditions. Any information given will be treated with confidence. Please read these terms and conditions carefully:

I pledge to raise a minimum of £1625 for St John Ambulance excluding Gift Aid
I am aware that I am required to submit at least £825 by Monday 1 April 2013, £1150 by Monday 6 May 2013 and full sponsorship fee by 3 June 2013 to St John Ambulance NHQ
I will agree to pay my non–refundable £100 registration fee to take part in this event
I agree to take part in the Virgin London Marathon 2013 at my own risk. St John Ambulance will not be responsible for any loss, damage, illness, injury or death caused or arising out of my involvement with this event
I am not aware of any medical condition or other reason why I should not participate or have provided a medical certificate allowing me to compete in this event
I will be over 18 years of age on the day of the event
If I do not take part due to illness or injury I understand that I do not have to raise the minimum sponsorship target, but if I can donate money to St John Ambulance, I will.
If I am unable to run the London Marathon 2013, I understand that deferring my place to London marathon 2014 will be at St John Ambulance’s discretion
All the information that I have provided is true and accurate.

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Address

St John Ambulance, 27 St John's Lane, London EC1M 4BU

Company details

Registered charity no. 1077265/1. A company registered in England no. 3866129.
Registered office: St John's Gate, Clerkenwell, London EC1M 4DA


Name*
Address*
Postcode*
Date of birth*
Email*
Mobile phone*
Home phone
Work phone
Occupation*
Employer
Please select you size?*
How did you hear about St John Ambulance's places in this event?*
If other, please specify
Predicted time*
Why do you want to run the London Marathon*
Are you aware of any medical condition(s) or other reason not to participate?*	Yes No
If yes, we will require a letter from your GP stating that you are able to train and compete in the London Marathon 2013.
Why do you want to raise money for St John Ambulance?*
We ask all runners to raise a minimum of £1,625 sponsorship; do you confidently think you could raise this?*	Yes No
How do you plan to reach your sponsorship target? Give details of any ideas and activities*
Is this your first charity running or sponsored event?*	Yes No
If no, please give details about your past charity sponsored events - when, who the event was for and how much you raised*
Have you entered the Virgin London Marathon 2013 Ballot?*	Yes No
If yes, if you got a place in the ballot would you still run for St John Ambulance?	Yes No
To confirm your place, you have to attend an exhibition in London a week before the race, are you able to attend this?	Yes No
If you didn’t get a place in the London Marathon, would you be interested in running the Brighton Marathon for St John Ambulance with a sponsorship pledge of £500?	Yes No
Have you, or a friend or relative, ever been treated by a first aider, treated someone yourself, or been involved with St John Ambulance in any other way (please give details)
If you already support St John Ambulance (eg. monthly donations, one-off donations, volunteering, etc) please tell us how
Would you be willing for your details to be shared with the PR team to help raise awareness of our work? We won't release your details to the media without contacting you first*	Yes No
St John Ambulance would like to keep you informed about our offers, activities, events and services (see data protection statement below).
Please keep me informed	Yes
Preferred communication methods	Email SMS Post
I have read all the below Terms and Conditions*	Yes No