Tandem Skydive*

Team member 1

Please note: each team member you list below will need to complete their own application form – the information below will only be used as reference so that we can group you together. It does not confirm or sign them up to take part in the Skydive with you until they have completed their own application form. Please forward them a link to this form so they can complete their details in full. If you have a team of more than 5 then please call us on 01372 461808.
Name of team member 1*

PrefixFirst NameLast Name
Preferred Name
Team member 2
Name of team member 2

PrefixFirst NameLast Name
Preferred Name
Team member 3
Name of team member 3

PrefixFirst NameLast Name
Preferred Name
Team member 4
Name of team member 4

PrefixFirst NameLast Name
Preferred Name
Team member 5
Name of team member 5

PrefixFirst NameLast Name
Preferred Name

Event details
If you would like a Princess Alice T-shirt, please let us know what size*
How did you hear about Princess Alice Hospice and our skydive events?
Other
Do you have any injuries that we need to be aware of?*

0/1000
Have you participated in any other sponsored events? If so, please provide us with examples, the charities you supported and how much you raised.

0/1000
Your sponsorship target - There is a minimum sponsorship of £450 for 10,000ft or £550 for the 15,000ft*
How do you plan to raise this money?*

0/1000
Do you belong to any groups or clubs?*

YesNo
If yes, which groups or clubs do you belong to?

0/500
Would you be interested in having a tour of the Hospice?*

YesNo
Enquiry pack*
Cancellation policy*
Declaration*

Keeping in touch

We’d love you to be part of the Princess Alice Hospice supporter community, but if we don’t have your permission, we can’t get in touch with you to share our latest news, campaigns and information about how you can support our work.
Would you like to hear from us by email?*

YesNo
Would you like to hear from us by post?*

YesNo
Would you like to hear from us by phone?*

YesNo
Rest assured, we never share, swap, rent or sell our supporters’ details to other charities or third parties for marketing purposes. You can read how we manage and respect your data in our Privacy Notice at www.pah.org.uk/privacy

If you’d like to change your permissions at any time please contact our Customer Experience Team on 01372 461808 or customerexperience@pah.org.uk
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