MND Association : Register

Title *

First Name *

Last Name *

Email Address *

Password*

Mobile *

Date of birth *

We’d love to keep in touch so we can tell you the huge difference you’re making

Yes No

(enter address manually)

County *

Country *

Would you like a #TeamMND tshirt or vest? *

Cotton Tshirt
Technical Tshirt
Running Vest
No thank you

How would you like to receive your fundraising pack? *

What prompted you to support us today?

Your connection to MND? *

How much are you hoping to raise? * (Please use whole numbers and do not use a decimal point when setting your target.)

£

Please confirm that you'll raise the minimum sponsorship *

Will your employer match your sponsorship?

Yes
No

Date of event

Please confirm the date of your event *

Before submitting your event registration, please take a moment to review our terms and conditions.

I agree to the above Terms & Conditions *

Register