Challenge Sign Up

Thank you for signing up to our challenge.

Personal Details (as per passport)
Postcode:  
Passport Details

Your passport must be valid for at least 6 months from the date of your return to the UK

Additional Information
Medical History

Please complete this section carefully. It is very important that we find out as much as possible about your medical history to ensure your safety on the challenge. We will treat your questionnaire with the strictest confidence. We will attempt to accommodate everybody on the challenge, but do reserve the right to refuse entry on medical grounds if we feel your safety and/or that of the group may be compromised. Any decision will be made in consultation with you.

Do you suffer from or have you ever suffered from:

Further Medical Details

If you answered YES to the question regarding asthma, please answer the following:

Emergency Contact

In case of an emergency, please contact:

Overseas Challenge Terms and Conditions

  • You must pay a registration fee of £300 for each application (either online, by post or over the telephone).
    This is non-refundable under any circumstances.
  • You must raise a minimum of £3000 sponsorship (exclusive of deposit): £2000 ten weeks before departure and the remainder (£1000) two weeks before departure.
  • If you are unable to meet the sponsorship requirements you may forfeit your place on the challenge.
  • All funds raised should be made payable to ‘International Childcare Trust.’
  • All flights will be booked through Action Challenge UK Ltd, ATOL 6296.
  • Where applicable, and unless stated, you must have a valid entrance visa for the country in which the challenge takes place.
  • Your passport must be valid for at least 6 months from the date of your return to the UK.
  • On receipt of your final payment, you will receive further trip notes, including an ATOL receipt to confirm your flight arrangements.
  • If you have any medical conditions that could be affected by strenuous activity, or you are over 60, you must get written clearance from your doctor. In signing below to the conditions you confirm that your general state of health and fitness is good and that you take full responsibility for yourself.
  • You accept that all instructions given to you on the challenge must be observed for your own safety.
  • You certify that all information you have provided on this application form and any further forms, is/are correct to the best of your knowledge.
  • You must have adequate insurance for the challenge. This must be sent to us 4 weeks prior to departure.
  • You must send a photocopy of your passport 10 weeks prior to departure.

Please inform the International Childcare Trust office if you do not want to receive information on future challenges or if you object to your email address being passed onto your fellow challenge participants.

In ticking to say you agree to these terms and conditions you understand and agree that your personal data may be processed and/or transferred outside of the European economic area in order for the full and proper performance of the challenge contract. I understand that Action Challenge UK Ltd. will only transfer to the extent required.

You give your permission for Action Challenge UK Ltd. or other expedition staff to initiate medical treatment and to inform my emergency contact if I go to hospital while on the event.
To the best of my knowledge, I have provided a true and accurate description of my medical history and my current physical condition.