Register Your Fundraising Event - Northern Ireland Chest Heart and Stroke
Northern Ireland Chest Heart & Stroke
Register Your Fundraising Event

Firstname

Surname

Address line 1

Address line 2

City

County

Postcode

Country

Contact Number

Email Address

What are your reasons for raising funds for NICHS?

Date of Event

Type of event

If you have selected "other" please specify:

How did you hear about this type of fundraising event?

Are you hosting this event at work?

Would you like to receive information about NICHS's work from time to time?

Declaration

***By submitting this form you agree to the NICHS 'Terms and Conditions' as listed below.***

1. I understand that NICHS will, in no way, be liable for any claim any injury or loss that might occur as a result of this event.*

2. I agree to send all proceeds of the event to NICHS as quickly as possible after the event.*