Walk registration form GHF

All persons, irrespective of age, can participate in the Galway Memorial Walk.
Persons aged 18 years and over must register for the event.
Persons under the age of 18 years are not required to register for the event.

1. Personal Details

Name*

First Last

Donor Code

If you have received a Memorial Walk letter, please enter your donor code (eg. A1234) as indicated on the bottom left of your letter.

Email*

Address*

Street Address Address Line 2 City County Postcode / Eircode Country

Mobile Phone*

Telephone

2. T-Shirts

Please choose ONE of the following options in the section below:

NONE: I already have a Galway Hospice Memorial Walk T-shirt and will be wearing it again this year.
NON-PERSONALISED: I would like a new non-personalised T-shirt with just the Memorial Walk Logo.
PERSONALISED: Personalised T Shirts - ‘I'm walking in memory of...’

T-Shirt Option*

None
Non-Personalised
Personalised

Please state below the name of the person whose memory you will be walking - max 27 characters*

I'm walking in memory of:

Confirm name to be printed on t-shirt*

Please confirm the name to be printed on the t-shirt to ensure no errors.

T-Shirt Size*

Please indicate your T-shirt size (Adult sizes only):

T-Shirt Delivery/Collection*

I can collect my T-Shirt
Please post my T-shirt to me

Choose your collection point:

Your t-shirt will be available for collection between 12 noon and 6pm on the day and at the location specified only.

Coral Leisure, Tuam – Thursday 3rd September
Coral Leisure, Ballinasloe – Friday 4th September
McD’s Home & Garden, Loughrea – Friday 4th September
The Boat Inn, Oughterard - Friday 4th September
McD’s Home & Garden at Galway Crystal, Dublin Road, Galway – Saturday 5th September

3. Sponsorship Cards

Sponsorship Cards*

How many Sponsorship cards would you like?

Setup-iDonate

Please tick this box to have an iDonate fundraising page set up for you.

Setup my Crowd Funding Page

4. Keeping in Touch

By submitting this form you consent to us using your details to provide you with information about the campaign you are registering for.

We would like to stay in touch with you about Galway Hospice services, news and fundraising activities.

Let us know how you would like us to stay in touch with you:

By e-mail
By post
By phone
By SMS
I do not want to be contacted

Please note we will retain your details on the Galway Hospice Donor database. We promise to keep your details safe and never sell or swap your details with third parties. Our privacy policy explains how we keep this promise. You can withdraw or change your consent at any time by contacting the Fundraising Department on 091 770868 or by fundraising@galwayhospice.ie or by using the opt out function available on all our communications.

Phone

This field is for validation purposes and should be left unchanged.

Walk registration form GHF – Fixed

Galway Memorial Walk Online Registration 2020(2)

1. Personal Details

2. T-Shirts

3. Sponsorship Cards

4. Keeping in Touch

Basket

Walk registration form GHF – Fixed

Galway Memorial Walk Online Registration 2020(2)

1. Personal Details

2. T-Shirts

3. Sponsorship Cards

4. Keeping in Touch