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Event Registration Form

Thank you for choosing a Challenge Central event.

To finalise your booking, please can we ask that you complete the registration form below which has been designed with your health and safety in mind.

All information provided will be treated with confidentiality.

Event Details

All fields marked with (*) are mandatory.

Challenge*

Pen-y-fan Trek

Booking Type*

Number of Bookings*

Personal Details Challenger 1

First Name(s): (as per your passport)*

Date of Birth:*

Gender:

Male Female

Address:

Email:*

Phone Number:*

Where did you hear about Challenge Central?

Promotional Code / Affiliate Code (if you have one)

*By providing an affiliate code, you are happy for Challenge Central to pass your contact details to the affiliate in order for them to make contact with you directly.

I confirm I have read and accepted the Terms and Conditions

This is a gift (please note that an automated booking confirmation will be sent to the email address provided. The email address can be changed at a later date if you wish to use your own.)

Personal Details Challenger 2

First Name(s): (as per your passport)*

Date of Birth:*

Gender:

Male Female

Address:

Email:*

Phone Number:*

Personal Details Challenger 3

First Name(s): (as per your passport)*

Date of Birth:*

Gender:

Male Female

Address:

Email:*

Phone Number:*

Personal Details Challenger 4

First Name(s): (as per your passport)*

Date of Birth:*

Gender:

Male Female