Thank you for your interest in connecting with others in the Challenge.

Register your details below and we'll post your responses on the Challenge website so others can contact you!

Note: by completing this form, you consent to your contact details being publicly available on the Challenge website.

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* 1. First name:

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* 2. Surname:

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* 3. Email address:

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* 4. Phone number: 
(we wont' post this on the website)

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* 5. Where do you work?

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* 6. Where are you based?

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* 7. I am...

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