This is where you register (you and or your team) for the HOPE Munster 4 Peaks 24-Hour Challenge 2012.

As places are limited, registration is on a first come, first served, basis until all places have been filled.

Please complete the form below and pay a non-refundable deposit of €25 per person. If your team members’ details are currently unknown, please leave the ‘team details’ box blank.

We will send you out a HOPE sponsorship card upon receipt of your online registration. This will enable you to get sponsorship from friends,
family, colleagues etc.

You can also set up a page for online sponsorship at: www.MyCharity.ie.

This is also an easy way to record how much you have raised. If you need help with this, please call Rosaleen on 086 806 9900.

Register Now

People Registering?	12345
Email Address *
Name of Team Captain *
Mobile *
Address*
Team Member 1*		Male Female
Team Member 2		Male Female
Team Member 3		Male Female
Team Member 4		Male Female
Team Member 5		Male Female
	IndividualTeam
Age Profile	18 - 2526 - 3536 - 4546 - 5556+
Company Name
How did you hear about the Challenge?	Christmas FMEzineFacebookFocus Ireland WebsiteGoogle Ad WordsLetter from Focus IrelandNewspaper;PostersPrevious SupporterRadioTVTwitterFriends/RelativesOtherVenue One
Have you donated or participated in a HOPE Event before?	Yes No
Do you participate in sports on a regular basis?	Yes No
If yes, in which sports do you participate?