SLEEP EASY ENTRY FORM 18 MARCH 2016
Name ……………………………………………………………………………...………………
Address …………………………………………………………….…………………………………………..
…………………………………………………………………………………………………………………………
Postcode …………………………………..
Telephone…....……………….……………………
Email ………………………………………….…………………….…… I enclose/will pay* £10 entry fee
Disclaimer - to be signed by all participants
I wish to participate in the Sleep Easy Sleepout on Friday 18 March 2016 in Horsham/
Brighton & Hove/Guildford*. I confirm that I am physically fit enough to sleep outside and
that the organisers will in no way be held responsible for any injury, loss or illness incurred to
my person as a result of this event. The same applies to my possessions. By signing here, I
give my consent for photos of me to be taken and used for publicity.
Signed …………………………………………………
Date …………………………………………….
If you have any medical conditions we should be aware of, please tell us here
……………………………………………………………………………………………………………………………
For 16-17 year olds parental consent is required
I consent to my child …………………………………………….. taking part in the Sleep Easy Sleepout.
He/she will be accompanied on the night by …………………………….…………………………………….
Signed …………………………………………………………… Name ………..……………………………………………
Emergency contact details - in case of emergency or accident on the night
Name ………………………………………………….…… Telephone ……………………………………
Relationship to you …………………………….……
Sleep Easy is a sponsored event
We ask all participants to raise sponsorship to help end youth homelessness (online via
JustGiving and hard copy forms also available). I’m hoping to raise £ ………………
Dietary requirements
A light breakfast will be provided on Saturday morning.
Vegetarian: Y/N* Other dietary requirements/allergies: ………………..………………
Why are you getting involved in Sleep Easy?
(This may be used for publicity purposes)
…………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………..
Please send your completed form and entry fee to Mrs Chris McSween, Guildford Y Centre,
Bridge Street, Guildford GU1 4SB or email to [email protected]
*Please delete as applicable