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Sign up to Rugby Ramble
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Participant information
Adult ticket
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Adult ticket quantity
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1
2
3
4
5
6
7
8
Person one's details
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First name
Surname
Email
Person two's details
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First name
Surname
Email
Person three's details
*
First name
Surname
Email
Person four's details
*
First name
Surname
Email
Person five's details
*
First name
Surname
Email
Person six's details
*
First name
Surname
Email
Person seven's details
*
First name
Surname
Email
Person eight's details
*
First name
Surname
Email
Do you require a child's ticket? (under 18)
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Child's ticket
Price:
Child's ticket quantity
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Please select
1
2
3
4
5
Child one's details
*
First name
Surname
Child two's details
*
First name
Surname
Child three's details
*
First name
Surname
Child four's details
*
First name
Surname
Child five's details
*
First name
Surname
Booker's details
Title
*
Miss
Ms
Mrs
Mr
Mx
Dr
First name
*
Last name
*
Address
*
Address Line 1
Address Line 2
City
County
Post code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Email address
*
Phone
*
Date of birth
*
Please note, under 16s must be registered and accompanied by an adult.
Day
Day
1
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29
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31
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
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1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Do you have any dietary requirements?
*
Yes
No
If yes, please let us know what these are
*
Do you have any medical conditions?
*
Yes
No
If yes, please let us know what these are
*
Emergency contact name
*
Emergency contact number
*
I’m signing up to Rugby Ramble because
I have a friend or family member being cared for by Birmingham Hospice
I am walking in memory of a family member
I am walking in memory of a friend
I would like to fundraise for Birmingham Hospice
I am fundraising with my company
I am a staff member or volunteer at Birmingham Hospice
Other
How did you hear about Rugby Ramble?
Social media
Email
Website
Flyer, postcard, banner
Previous participant
Word of mouth
Other
By signing up to this campaign, you are consenting to receiving ALL information about this campaign. We would ALSO like to keep in touch with you about our vital work and update you on our news and fundraising activities. Please tell us if you would be happy for us to contact you:
By email
By SMS
We may also contact you by telephone and/or post. If you wish not to be contacted by post or telephone, please tick here:
Opt out of telephone
Opt out of post
By signing up to this event I agree to the following T&Cs:
*
1. I / we accept that by signing up to this event I / we are consenting to receiving ALL information about this event, including a fundraising pack and sponsorship forms. I / we accept the responsibility of informing Birmingham Hospice should I wish not to receive event specific communications. 2. I / we acknowledge that Birmingham Hospice will take all reasonable steps to minimise the risk of accident or injury to participants during this event. I / we accept full responsibility for ourselves whilst participating in this event and understand that Birmingham Hospice cannot accept liability for any loss or damage to personal property, injury or death. 3. I / we confirm that I am sufficiently fit and healthy to take part in this event. Should this change, I / we will seek medical advice prior to the event. 4. I / we confirm that I/ we are over the age of 18 years old. I/ we understand that under 18 year olds must be accompanied by a registered adult at all times. 5. I / we understand that Birmingham Hospice may photograph or film me as a participant, and that such photographs and footage may be used for commercial and / or fundraising purposes in the future. I / we accept the responsibility of informing Birmingham Hospice should I wish to not be photographed. 6. I/ we take full responsibility for any costs attributed to our participation in this event and will not deduct any expenditure from funds raised. I / we accept the responsibility to ensure that all fundraising monies/donations received in connection with this event are paid to Birmingham Hospice (we kindly ask that you do this as soon as possible after the event). 7. I / we accept that should I / we no longer be able to take part in this event, I / we will be unable to claim a refund for my registration fee. Any sponsorship collected will be refunded to the donor or gifted to Birmingham Hospice on instruction 8. I / we agree to abide by any rules, instructions and regulations given before, or on the day of the event by event officials. I / we accept Birmingham Hospice’s right to refuse entry to participants. 9. I / we accept that Birmingham Hospice reserves the right to reduce, alter, change or cancel the event to accommodate unexpected conditions or complications on the day that may affect participants, volunteers and staff.
I agree
Total
Coupon
Credit Card
*