Donation 1

Registering for 2017 biggest loser!

Hi all please fill the below in carefully to apply for the biggest loser 2017 with #SupportingLocalChampions. Any questions please don't hesitate to contact us on our contact section or via Facebook.
Success! Your Application Has Been Submitted - Thank you & Good Luck.
Your Name:

Name of nominee:

Contact Num:

E-Mail Address:

Weight as of 1st January 2017:

Any present medical issues?

Current Work Commitments:

Reasons for a place on biggest loser 2017?

  • If you are nominating someone other than yourself please put "None" in weight and medical sections.
  • Must be local to the North East lincolnshire area
  • By completing this registration you agree to be part of a fundraising team for the duration of the Biggest Loser.
  • Remember: If nominating someone else please fill in the nominee name.