Heart Foundation's MyMarathon : Register

Joining Team Mixed Impakt

First Name *

Last Name *

Email Address *

Password*

Mobile *

Date of birth *

Shirt Size *

When you raise $90 we’ll send you a FREE MyMarathon T-shirt and pack for your challenge!

Please confirm your shirt size and postal address.

(enter manually)

Address Line 1

Address Line 2

Town/Suburb

Postcode

Region

Country

Why are you taking on this challenge to help save Kiwi hearts? *

By submitting this form you accept the Heart Foundation’s Terms and Privacy.