Challenge badge sign up

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)

School / group or organisation county(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.

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Email

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Phone

SMS

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.

Email

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