Name (required)

Address

City

Postcode

Contact number

Email Address (required)

Region (required)
Archie GrampianArchie HighlandsArchie TaysideArchie Global Surgery

Date of Birth (required)

Gender(required)

Please tell us about your planned fundraiser - what is it you're doing?

Date(s) of your event?

Do you have a target amount of money you would like to raise?

Have you set up and online fundraising page? If yes, please enter the url below

Sponsor forms - If you would like some sponsor forms mailed out then please select the quantity

Merchandise

We would like to support you by offering some merchandise to support your fundraising. We will send this out through our free courier service, generously provided by Menzies.

Please select from the following items:

T-Shirt (unisex)
Please say how many you need and what size (3-4 years, 5-6 years, 7-8 years, 9-11 years, XS, S, M, L, XL, XXL)

Available to those completing 10K + running events:

Short Sleeved Running Top
(size: XS, S, M, L, XL) indicate male or female and number required

Long Sleeved Running Top
(size: XS, S, M, L, XL) indicate male or female and number required

Available to those completing cycling events:

Cycling top (unisex)
Please say how many you need and what size (size XS, S, M, L, XL)

Collection cans (qty)

Collection buckets (qty)

Any other questions or information you would like?

Other merchandise is available including balloons and banners, information leaflets etc..

Keeping in touch - please select your preferences

I am happy for my personal information to be used to:

Contact me during my fundraising, including to offer tips on fundraising and how to make my donation:Contact me about future fundraising events:Contact me about opportunities to volunteer/get involved in fundraising:Contact me about how to sign up for our newsletter:Contact me about how to leave a legacy in my will:

I am happy to be contacted via:

Post:Email:Telephone:Text message:

If applicable, I understand that I should seek medical advice from my GP if I am in any doubt about my physical ability to take part in this activity. I acknowledge that I am undertaking this activity entirely at my own risk and that The ARCHIE Foundation shall not be held liable in any way for any injury or loss that might occur as a result of my participation. I understand that The ARCHIE Foundation will, in no way, be liable for any claim that may arise from this activity. I agree to pay all proceeds from the activity to The ARCHIE Foundation. I confirm that I am 16 years or over, or that my parent or guardian has approved my participation in this activity. (Tick to confirm)