Register as an Individual | Walk With Me 2026

Thank you for your interest in joining HCA Hospice – Walk With Me 2026!

Required fields are denoted by *.

Account Details
Personal Information
Consent

Account Details

Email Address (Login ID) *

Make sure your email address is correct. Event updates and instructions will also be sent there.

Confirm Email Address *

Account Password *

Confirm Account Password *

Account Display Name *

Preferred T-Shirt Size *

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I got to know about this event through...

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Personal Information

Full Name (as per NRIC/FIN/Passport) *

Mobile Number *

Date of Birth *

Gender *

Emergency Contact

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Mobile Number *

Medical History

Blood Group *

Allergies to any medications (If any)

Current or past medical conditions that our medical personnel should be aware of (If any)

Consent

Health Declaration *

I confirm that I am medically fit to participate in the event and have assessed the accessibility level of the route for my own participation. I acknowledge that despite the organisers taking all reasonable safety measures, inherent risks remain in my participation and I accept full responsibility for my decision to take part. I will not hold the organisers responsible for any injury, loss or damage arising from my participation.

Parental/Guardian Consent *

I, the parent/guardian of the participant, has read the rules and regulations of the event and allow the participant to sign up and take part in this event. I shall not hold the organiser, its officers, staff, volunteers, agents, contractors, event officials, event sponsors and event partners from all and any demands, claims, liabilities, proceedings, suits, losses and/or damages of any kind whatsoever arising out of or in connection with his/her participation in the event, including without limitation, personal injury and/or death.

Parent/Guardian's Name *

Parent/Guardian's Contact Number *

Terms and Conditions *

I have read and agree with the stipulated Terms and Conditions.

PDPA Consent *

By continuing to use the Organiser's services relating to the Event, accessing any part of the Official Website, registering for the Event, submitting information to the Organiser (and/or its related entities) whether for the purpose of registering for the Event, pledging a donation or otherwise in relation to the Event, and in addition to the personal data protection consent having been executed by the Participant, the Participant expressly agrees and consents to the Organiser's (including its related entities, as well as their respective agents') collection, use and disclosure of his/her personal data for all and any purposes relating to the Event, including but not limited to the following:

to collect, analyse, collate, share, disclose to third parties, and/or otherwise use without any liability to the individual, any personal information relating to that Participant as the Organiser may in its sole discretion deem fit, including without any limitation, for Event registration, administration, management and follow up, and for its programmes, planning, data- processing, and statistical or risk-analysis, research, fundraising and/or any other purposes relating to the Event.
to post the total funds raised through the Participant on the Official Website of the Organiser or on all and any other physical or electronic media whatsoever, now known or later developed;
to use any photographs, motion pictures, recordings, or any other records of the Event and of the Participants, Participants' supporters, sponsors, volunteers, and partners (“Participant Media”), for any legitimate purpose, including commercial advertising and distribution to Event sponsors.

Communications *

Please add me to your mailing list for future updates on HCA events and initiatives (non-walk related)

Enter Promo/Corporate Code (If any)

Note: Promo/Corporate codes are issued by HCA Hospice. Do email to [email protected] if you face any issues using your promo code.

Payment Mode *

Payment Summary

Registration Fee

$31.20

Promo Code Special

-$0.00

Total Amount

$31.20