Event Registration Form

Event Details

What event or activity are you taking part in? (required)

When does it take place? (required)

Your Details

Title (required)

First Name (required)

Surname (required)

Address (required)

Town (required)

County (required)

Post Code (required)

Phone number (required)

Email (required)

Occupation

Please choose your communication preferences. Rest assured, we never share, swap, rent or sell your details to third parties for marketing purposes. You can read how we manage and respect your data in our privacy policy www.straphaels.org.uk/policy-notice (required)

EmailPhonePostText Message or WhatsappPlease tick if you do not wish to be contacted by us at all (please note that we will contact you with vital information about your event but will not contact you further in the future)

Please select your t-shirt size? (required)

Your Story

Why do you want to take part for St Raphael’s? (required)

If you are taking part in memory of someone please let us know their full name?

Where did you hear about taking part in your event for St Raphael’s? (required)

Any further comments

Thank you for supporting St Raphael’s Hospice. Your fundraising is so appreciated by all of us and will make such a big difference to our patients and their families.

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