London Walk Registration Form

Are you ready to go the distance for victims of online harm?

The London Stock Exchange Group and The Cyber Helpline are teaming up to raise vital funds for victims of cybercrime, digital fraud and online harm. Please register here for the walk, and we will send you the event information pack.

Your details

Name

First Name

Last Name

Date of birth

YYYY

Phone number

Country

(###)

###

####

T-shirt size

We may be able to provide t-shirts for the day. If we can, what size would work best for you.

The event

Which distance would you like to cover?

Would you like to walk or run the distance?

Medical

Subject to the information you give below, a medical professional may be in touch prior to the event to talk through any details. Please write ‘None’ if any do not apply.

Please inform us of any medical conditions, including allergies or medications, to be aware of

Please inform of us of any health conditions (physical or otherwise) we need to be aware of, and any special requirements you might require to participate in the event

Emergency contact details

Please provide us with contact details of someone we can get in touch with on the day should anything happen. Please don’t give us details of anyone walking with you.