Event Registration Form

Name*
First Last
Email*
Phone*
Address*
Please complete ALL fields

Address Line 1 Address Line 2 City / Town County Eircode Country
Fundraising Event Name*
Date Of Event*
Date Format: DD slash MM slash YYYY
Fund-raising for
- Bee for Battens
- BUMBLEance
- Liam's Lodge
- Saoirse Foundation
- Where it is needed most
Describe Fundraising Event*
Do you require any T-shirts?
- Yes
T-shirts
Please leave a note telling us how many t-shirts you would like to order in each size. Adult sizes XS, S, M, L, XL, XXL, XXXL Child sizes 1-2, 3-4, 5-6, 7-8, 9-10 , 11-12
Other promotional material
Please indicate if you would like posters, stickers and / or collection buckets:
Do you require any Sponsor cards?
- Yes
Number of Sponsor Cards
Please enter a number from 0 to 200.
DECLARATION
I declare that the information provided in this document is correct, and by submitting this form, I agree that I or any other person associated in the organisation of this activity will not profit/benefit from this event and any/all funds raised will be transferred to the supplied bank accounts of The Saoirse Foundation BUMBLEance Children's National Ambulance Service.
I understand that by submitting this form, I consent to being contacted according to the terms of The Saoirse Foundation BUMBLEance Children's National Ambulance Service Privacy Statement.
- Please tick to confirm
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DECLARATION