Swim Serpentine 2023 application

Title *

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Gender *

Female
Male
Non-binary
Other (please specify)

Age *

Have you taken part in Swim Serpentine before? *

Yes
No

Have you swum for charity before? *

Yes
No

Why do you want to swim for MS-UK? *

Which of the following best describes your connection to multiple sclerosis?

other

How did you hear about MS-UK's Swim Serpentine places?

other

Please let us know which other fundraising activities/events you would like to hear about (tick all boxes that apply)

I agree to the terms and conditions *

Yes
No

- You must be at least 18 years old on event day to take part in Swim Serpentine 2023 - Accepting an MS-UK charity place is a commitment to raise at least £200.00 for MS-UK - Sponsor money should be sent to MS-UK no later than 11 November 2023, which is eight weeks after the event - You understand that if your fundraising is less than £200.00 after 11 November 2023 you will be responsible for paying the balance to MS-UK Gift Aid does not count towards your sponsorship total - Accepting a MS-UK charity place means you agree to only fundraise for MS-UK. Any online donation pages must be 100% fundraising for MS-UK - Although you have secured a place through MS-UK, you will also need to register your details with the event organisers. This is a health and safety requirement and will ensure you receive your swimmer number and race day information. We will advise you of when we are ready for you to do this. Failure to not complete the registration means will not be able to take part in Swim Serpentine 2023 and this is outside of MS-UK’s control - If you need to withdraw from Swim Serpentine 2023, please let us know as soon as possible and by no later than Friday 28 July 2023 - Photographs and video footage taken at this event may be used for publicity purposes - You participate at your own risk

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my enquiry.