Sample participant consent form – Tough Mother

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Participant consent form

Tough Mother: Zero to Hero – Adventure challenge for charity

Dear Participant,

Thank you for joining the “Tough Mother: Zero to Hero” challenge! Organised by [Charity Name], this event offers a chance to experience the endurance and resilience required by those facing hardship, while raising funds for refugees.

Please read the information below carefully and complete the form to confirm your participation.

Event overview

Date of challenge: [Insert Date Here]
Location: Holmwood Common and Henfold Lakes, Surrey
Activities include: Endurance trek, assault course, and reflection sessions

Purpose:

  • Fundraising for refugee support – Raise essential funds to support refugees through sponsorship.
  • Simulating refugee experiences – Foster empathy by participating in challenges that simulate refugee trials.

Challenge requirements

  • Arrival & dress You will be collected from your local mosque by minibus. Please wear abaya, hijab, trainers, and bring a packed rucksack containing a full change of clothes.
  • Endurance tasks: Includes a 1-hour trek, various obstacles, crawling through muddy ditches, and wading through water.
  • No fitness experience required: The challenge is for everyday mums rather than fitness enthusiasts.
  • Fundraising: Each group will create a fundraising page to raise sponsorship for the charity’s work with refugees.

Health & safety

This event involves physically demanding activities. Safety personnel, including trained staff from [venue name] and medical staff from [first aid provider], will be present throughout the course.

Please notify us of any health concerns that might affect your participation.

By signing below, you agree to the following:

  1. I understand and accept that the Tough Mother: Zero to Hero challenge involves physical exertion and activities such as trekking, crawling, climbing, and wading through water, which may result in my clothes becoming wet and muddy.
  2. I confirm that I have been informed of the nature of the activities and that safety staff and medical personnel will be present throughout the challenge.
  3. I agree to create a fundraising page and to actively seek sponsorship, supporting the charity’s refugee initiatives.
  4. I understand that photographs and video recordings may be taken during the event, which may be used by [Charity Name] for promotional purposes.
  5. I will inform the charity of any medical conditions or injuries that may impact my ability to participate in the event.

Participant’s Name: _______________________
Signature: ______________________________
Date: ___________________________________
Emergency Contact Name and Number: _______
Relevant Medical Information (if any): ____

Important reminders

  • Training and preparation – Light training sessions are encouraged before the event.
  • Sponsorship – Share your journey to motivate others and raise awareness.

Thank you for taking on this challenge and supporting refugees. We look forward to an unforgettable day of teamwork, resilience, and positive impact.

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