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Adult's Care
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Contact Us
Support us
Virtual Gifts
Fundraising
Events
Lottery
Pay for a Day
Leaving a Gift in your Will
Herd In The City
In Memory
Our Shops
Corporate Partnerships
Join Us
Careers at Havens Hospices
Job Vacancies
Nursing Careers
Volunteering at Havens Hospices
Volunteer Roles
Occasional Volunteering
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Application for Royal Parks Charity Places
Tell us about yourself
Name
*
Dr.
Miss
Mr.
Mrs.
Ms.
Prof.
Rev.
Title
First
Last
Address
*
Street Address
Address Line 2
City
Postal Code
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
Country
Date of birth
*
Phone number (daytime)
*
Second contact number
Please provide your home or mobile phone number
Email address
*
Have you run a half marathon before?
*
Yes
No
Have you supported Havens Hospices before?
*
Yes
No
Team Havens 2021
We will ask you to pledge to try and raise £250 for Havens Hospices. Please note any monies you have raised from deferred events will be carried over to this event. If successful with your application you will be invited to join Team Havens 2021 and we will send out a welcome pack to you.
Wear a Havens Hospices vest with pride
We’d love you to wear a Havens Hospices running vest while you train and on the big day. Let us know your size so we can send you one!
Running vest size
*
SML
MED
LGE
XLGE
XXLGE
So that we get it right and only contact you in the right way. Please select your preference/s in how we contact you.
*
By email
By phone
By post
We will update these preferences for you, if anything changes please get in touch. You’re in charge of what information Havens Hospices has about you, and what you want to receive from the charity. Everything is laid out in our Privacy Policy which you can read on our website. But you can change how we contact you by emailing changeme@havenshospices.org.uk, visiting www.havenshospices.org.uk/update or calling 01702 220345.
Thank you for applying to run for Havens Hospices
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