Additional information (e.g. names of additional participants or anything else we might need to know)
On behalf of a companyOn behalf of an organisationOn behalf of a school/college/universityAs an individual
Have you set up your own online giving page (e.g. Just Giving, Virgin Money Giving etc)?
If yes please enter the web address for your page
Where would you like the money to go?
Your first name (required)
Your last name (required)
Address line 1 (required)
Address line 2
Your Email (required)
Please enter your business details including the name of the business, your role, the address and main phone number
Please tell us why you have chosen to support us
Please tell us how you heard about our appeal (required)
I would like to hear more about supporting Birmingham Women's Hospital by
By completing this form I agree to donate all the proceeds from the above event to Birmingham Women's Hospital. Under no circumstances will I divert any money raised in this name to any other organisation or individual, without the full knowledge and consent of Birmingham Women's Hospital. I understand and agree that Birmingham Women's Hospital does not accept any responsibility for this event or activity. I understand and agree that I am undertaking this event or activity at my own risk and that Birmingham Women's Hospital is not responsible for any risk, injury, loss or damage that may result and will not be liable for any claim which may arise.
We have lots of fabulous fundraising materials available to help you with your fundraising event, including banners, balloons, stickers, posters, leaflets, collection tins and more! Please do let us know when you are speaking to the team, so that we can ensure you have everything you need to help make your event the best that it can be.