Stroke Association

If you already have an account, please click here to login before completing this form.

Thank you for your interest. So that we can assist you with your enquiry, please complete and submit the form below. Please note that by completing and submitting this form, you are giving us your consent to securely pass on your information to Stroke Association, and a free membership account will be created for you on our website.

Event

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First name

Last name

Phone number We ask for your telephone phone number as a secondary form of contact. It is not mandatory, but may prove to be helpful as part of your application. Your phone number will only be used in relation to this application and will not be passed on to third parties.

Why do you want to participate?

Fundraising target: £1000

To apply for one of our limited charity places in the Berlin Marathon, please complete our online application. Your application must include as much detail as possible about why you wish to raise funds for the Stroke Association and how you will exceed the minimum sponsorship target of £1000 (excluding gift aid). Please note that if your application is successful, a £50 registration fee is required to secure your place.

How much do you pledge to fundraise?

How will you meet your fundraising goal?

By clicking on the Submit button below:

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