Register your interest in a challenge

Please complete and submit the form below to register your interest in a challenge and our events team will be in touch with more information.

First name*
Surname*
Email address*
Phone number*
Challenge you are interested in:*
Want to find out how you've made a difference?
We can only send you information on the impact of your fundraising - plus how you can work with us to change the lives of even more women and children through donating, fundraising, campaigning and volunteering - if you tell us how you'd like to be contacted.
I am happy to receive emails from Refuge*
- Yes, I am happy to receive emails from Refuge
- No, I do not want to receive emails from Refuge
I am happy to receive texts from Refuge*
- Yes, I am happy to receive texts from Refuge
- No, I do not want to receive texts from Refuge
If you would prefer not to receive calls or post from Refuge, please tick the relevant box below:
- I would prefer not to receive calls from Refuge.
- I would prefer not to receive post from Refuge.
Name
This field is for validation purposes and should be left unchanged.

Freephone 24-Hour National Domestic Abuse Helpline: 0808 2000 247
or visit www.nationaldahelpline.org.uk (access live chat Mon-Fri 3-10pm)