Great North Run 2021 application Apply for a place in the 2021 Great North Run and be part of #TEAMBROOKE Event Event * Brooke has a limited number of Great North Run places. We'd love for you to run for Brooke and we'd like to know a little about how you plan to raise the £390 for Brooke. Applications are assessed on a regular basis, so we will let you know quickly if you have a place with Team Brooke. If you're successful, we ask that you commit to raising a minimum of £390 (excluding Gift Aid) for Brooke, as well as paying a non-refundable £45 entry fee. The money you raise will help us work towards our vision of a world in which working horses, donkeys and mules are free from suffering. These animals support the lives of around 600 million people in some of the world's poorest communities. Your details Title * - Select -MrsMsMissMrDr First name * Last name * Email address * Phone number (home) Mobile number Address line 1 * Address line 2 Town * County Postcode * Country * AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong S.A.R., ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe Date of birth * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999 Entrants must be 18 years old or above on race day. Fundraising details Your ability to fundraise is a a key factor when we offer our Great North Run places which is why we ask you to please answer the following questions. What is your motivation for running for Brooke? The Simplyhealth Great North Run is a very popular event and spaces are limited so your motivation is very important. Tell us why you want to run for Team Brooke. Predicted fundraising total * £ Minimum sponsorship of £390 required. How will you fundraise to hit this target? * To help with your application, please give us as much detail as possible of your fundraising plans- eg: at work, online, schools, social media, organising fundraising events. How we contact you Your support is important to us and we would like to keep you updated about Brooke news, events, activities (including fundraising and appeals) and how you can support us. We will send you information by post that we believe you will be interested hearing more about. Are you also happy for Brooke to contact you in the following ways for these purposes: Email * Yes No Phone * Yes No SMS text * Yes No You can update the ways in which we contact you or inform us that you no longer wish to hear from Brooke at any time. Please call us on 020 7470 9393, email us at [email protected] or write to us at Brooke, 2nd Floor, The Hallmark Building, 52-56 Leadenhall Street, London, EC3A 2BJ. Brooke will use the relevant personal data you provide in order to process your request. Your contact details will be used by Brooke to communicate with you in the ways you have indicated above. We may analyse your data and add publicly available information to create a profile of your interests and preferences. Please see our privacy statement for further information about how we will use your personal data. You can also contact us for a copy (details above). I understand that if my application is successful, I must pay the registration fee of £45 and pledge to raise a minimum of £390 for Brooke. Agreement * I agree to raise the minimum sponsorship amount of £390 (this excludes Gift Aid) Leave this field blank Share this WhatsApp Facebook Twitter Linkedin Mail