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Test superhero form
Register your interest to take part here:
(Required)
I would like a charity place in the Superhero Triathlon and commit to a £250 fundraising target and £10 registration fee per person
I already have a place in the Superhero Triathlon and want to join Team SIA
Are you participating as an individual or as part of a team?
(Required)
As an indivdual
As part of a team
Please tick the box to confirm you are aware all solo entrants must consider themselves to have a disability of any kind
(Required)
I am aware that to take place as an individual I need to consider I have a disability
Please tick the box to confirm you are aware that to take part at least one of your team members must consider themselves to have a disability of any kind
(Required)
I am aware that at least one team member needs to consider they have a disability
Name
(Required)
If you are entering as part of a team please ensure that all members of the team register using this form.
First
Last
Address
(Required)
Street address
Town/City
County
Postcode
Phone
(Required)
Email
(Required)
Please provide the name and phone number of your emergency contact.
(Required)
First name
Last name
Emergency contact phone number
(Required)
What is your date of birth
(Required)
Day
Month
Year
How would you prefer to be contacted?
(Required)
By Email
Over the phone
In writing
Any of the above/no preference
Would you like to be added to the WhatsApp group approximately one week prior to the event?
Yes I would like to be added to the WhatsApp group
No I do not want to be added to the WhatsApp group
What is your team called?
(Required)
This will help us identify other members of your team.
What made you want to take on a challenge for SIA?
(Required)
Which distance will you be doing?
(Required)
Sprint: Swim 150m, Bike 3k, Push/run 1k
Half: Swim 400m, Bike 10K, Push/run 2.5k
Full: Swim 750m, Bike 20k, Push/run 5k
What part of the triathlon will you be taking part in? (tick as many as apply)
(Required)
Swim
Push/Run
Cycle
All three
Do you require assistance getting in and out of the water?
(Required)
Yes
No
Will you be using a vessel (canoe/kayak/inflatable, etc.) to tow one of your team on the water for the swim stage.
(Required)
It's super important we know this at the booking stage to ensure we can accommodate your vessel on the day. Thank you.
Yes, I will be using a vessel (canoe/kayak/inflatable, etc)
No, I will not be using a vessel (canoe/kayak/inflatable, etc)
Please tick the box to confirm you are aware that if the participant being towed does NOT plan to enter the water at any point, they do not need a wetsuit, but must bring a well-fitted life jacket/buoyancy aid to wear.
(Required)
I confirm I understand and accept the above statement
Please enter any information we may need to know about your disability or requirements
(Required)
Will you be taking a 'side kick' (PA/carer/assistant) who will be assisting you during the triathlon i.e. in the water or on the track?
(Required)
Yes
No
To help the team allocate wave times, please tick the box if you estimate your team will take longer than three hours to complete your tri mission.
Yes we estimate it will take us longer than three hours to complete.
No we estimate we will not take longer than three hours to complete.
If you're currently employed does your employer:
(Required)
Assist staff in fundraising activities and challenges
Offer matched-funding
I am not sure if they allow staff fundraising, or if they offer matched-funding schemes
No they do not allow staff fundraising or offer matched-funding schemes
Not applicable
If you are happy to, please tell us who your employer is below:
We will send you a fundraising pack. Would you prefer:
(Required)
A fundraising pack to be sent to you in the post?
An electronic version to be emailed to you?
Both?
Your welcome pack includes a free T-shirt. What size would you like?
(Required)
Please note all sizing is unisex
Extra Small
Small
Medium
Large
Extra Large
XX Large
Fitness Declaration
(Required)
By signing this declaration to participate in this event, I acknowledge and understand that I am participating at my own risk. I agree that - to the best of my knowledge – my general state of health and fitness is good enough to allow me to compete in this event.
I agree to the above.
General Terms and Conditions of Participation
(Required)
In taking part in this event on behalf of SIA, I give permission for SIA to use any photographs, videos or testimonials taken throughout the course of the event to be used to further raise funds or awareness for the charity throughout all media channels.
I agree to the terms and conditions of participation
Registration fee for Superhero Triathlon
(Required)
Price:
Total
Credit Card
Are you happy for us to contact you in the future?
(Required)
SIA would like to keep you informed about our campaigning and services, appeals and others ways you can support our work. Your support and involvement with SIA helps us to empower spinal cord injured (SCI) people and their families to live fulfilled lives.
Yes please
No thank you
Email
This field is for validation purposes and should be left unchanged.
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