Fundraiser Registration Form
/Confidential
Please complete this form as fully as you can. If you have any questions regarding your plans then please contact us. Fields marked with a * please delete as applicable.
Title: / First Name(s): / Surname:Address:
Post Code:
Tel: / Mobile:
Email:
Type of event or activity:
Date of event/activity: / Venue:
Sponsor forms required?
YES/NO* / T-Shirt required? YES / NO*
Size: S, M, L, XL, XXL*
Collection Boxes required?
YES/NO* / Collection Buckets required?
YES/NO*
Comments and requests:
- If you are raising money in your workplace please provide the company’s name and contact details on the reverse of this form.
- If you are raising money as part of a team or group, and those people are also raising money for Blue Skies Hospitals Fund, please provide their names and addresses on the reverse of this form.
- Please read and sign the Fundraising Agreement at the end of this form in order that we may issue a letter of authority to fundraise.
Company name:
Name of contact:
Address: / Postcode:
Main phone no:
Website address:
Name of Team or Group:
Title: / First Name(s):
Surname:
Address: / Postcode:
Title: / First Name(s):
Surname:
Address: / Postcode:
Title: / First Name(s):
Surname:
Address: / Postcode:
FUNDRAISING AGREEMENT
Whilst raising money for Blue Skies Hospitals Fund I will:
- Confirm that I am over the age of 18 - if you are under the age of 18 please contact r help and support
- Use my best endeavours to raise money for Blue Skies Hospitals Fund and make clear that I am fundraising in aid of Blue Skies Hospitals Fund but that I am not a representative of Blue Skies Hospitals Fund..
- Not do anything to bring Blue Skies Hospitals Fund, its volunteers or trustees into disrepute.
- Show the charity any materials that I produce that bear Blue Skies Hospitals Funds name or logo, or that mentions the work of the charity prior to distribution.
- All materials I produce will include the text Registered Charity Number 1051570.
- Not carry out house to house collections.
- Ensure that before collecting in a public place, I'll obtain a licence from the local authority.
- Not shake a collection tin or bucket, as this is prohibited by law.
- Not collect on private property (including shops, pubs etc) without first obtaining permission from the owner.
- Obtain a raffle licence from my local authority if holding a raffle over more than one day – please contact for help and support.
- Have two people present when any monies collected are being counted.
- Abide by any and all data protection laws.
- Abide by all health and safety laws.
- Not align my fundraising to any political party or candidate.
- Acknowledge that Blue Skies Hospitals Fund cannot take responsibility for any losses made through my fundraising activity and ensure that any necessary insurances and risk assessments are in place to support the safety of participants.
- Return any unused fundraising materials to Blue Skies Hospitals Fund.
- Obtain and pay to Blue Skies Hospitals Fund all money raised from my fundraising no later than four weeks after my event is finished.
- I understand that Blue Skies Hospitals Fund may terminate my right to raise funds at any time.
Signed: Date:
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Due to changes in data protection legislation,we soon won't be able to contact you about any of our activities unless we have your explicit consent to keep in touch with you. In other words, if you would like to receive news and updates on our events, campaigns and successes,we need your tick!
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