Challenge badge sign up

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Complete the below form to sign up to the East Anglian Air Ambulance challenge badge!

About you

First name(Required)

Last name(Required)

Email(Required)

Phone number(Required)

School / group or organisation name(Required)

How many young people are taking part?(Required)

When would you like to start?(Required)

Please note: We need at least two weeks between form submission and your planned start date to process and dispatch your challenge badge booklets.

Address(Required)

Please note: This address is where you would like your Challenge Badge booklets sent to.

Address line 1 Address Line 2 Postal Town County Post code Country

How would you like to be contacted by us?

We value your support and would like to keep you informed about our ongoing progress, campaigns, competitions and fundraising opportunities. Please tell us how you most like to be contacted by us.

I am happy with how I hear from you, don’t change my preferences.

If you don't want to hear any further from us, please tick here.

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Post

Phone

SMS

18 +

I am over 18 (we may contact you about our lottery, raffle or other products).

We always treat your data with respect. Please read our full privacy policy. It's easy to update your preferences at any time. Just contact us at info@eaaa.org.uk or update your details online via our preferences page.

Name

This field is for validation purposes and should be left unchanged.