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Date of Birth *

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Have you previously participated in The Bloody Long Walk *

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Do you have a personal connection to mitochondrial disease (mito)? *

Does your employer offer matched giving? *

Yes
No

UNDER 16 PARTICIPANTS

The date of birth that you have entered indicates that this entry contains an entrant under the age of 16. Please remember that as per our terms and conditions, participants aged U16 will need to be accompanied at all times during the event by a parent/guardian who has also registered for The Bloody Long Walk.

I acknowledge that The Bloody Long Walk is a fundraising event and will try my bloody hardest to raise at least $10 per kilometre ($350) to help find a cure for mitochondrial disease

I agree to the terms and conditions. I confirm that I am medically and physically fit and able to participate in the Event.

PERTH 2026

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