ArcelorMittal Orbit Abseil 2023

Name *

First

Last

Email *

Mobile Number *

Date of birth *

Gender *MaleFemaleOtherPrefer not to say

Organisation (place of work/study) *

Job Title

Are you planning to abseil as an individual or as a pair / group? *IndividualPairGroup

If abseiling as a pair / group please let us know the names of your group below. Please note, they will also need to complete this ballot form.

Why would you like to abseil for LLST? *

Places cost LLST £90. Are you happy to make a contribution of £25? *YesYesNo

Are you happy to commit to raising at least £250 for LLST? *YesYesNo

Emergency contact name *

Emergency contact number *

Any other comments:

By submitting this form you agree to the London Legal Support Trust's Privacy Policy https://londonlegalsupporttrust.org.uk/privacy-policy/ *

• I Agree

Phone

Submit