Tough Mudder Application Form

£ 25.00
Thank you for your interest in taking on Tough Mudder as part of #TeamRetinaUK! To apply for one of our places please complete this form. A £25 registration fee is also required when you apply. Registration fees are only refundable if we are unable to offer you a place. Please note - filling in our application form does not guarantee you a charity place. Places aren't guaranteed until you've been offered a place by a member of the team. Once you have been confirmed as a runner for “TEAM Retina UK” we will send you a fundraising pack. If you have any questions please contact Emily Webb on 01280 815900 or email
Personal Info

Billing Details


Donation Total: £25.00