Charity event own place registration

Thank you for choosing to raise funds for the Macular Society. Together we can support those with the disease and fund research so that one day we may find a cure.

Our team are here to support you with your event in any way we can.

Meanwhile if you have any queries please contact the Community and Events team on 01264 321 964 or community@macularsociety.org

Activate Form Reader

Required fields are indicated by *

Contact Details

Title*

Other Title

First Name*

Last Name*

Email*

Phone

Mobile

Address Details

Postcode*

or enter address manually

Address:

Address Line 1*

Address Line 2

Address Line 3

Town/City*

Region

Which event will you be taking part in?*

When is the event?

Where did you hear about the event

Where did you hear about us other

please specify

I understand I should seek medical advice from my GP if I am in any doubt as to my physical ability to take part in this event*

I confirm that I am taking part in this activity entirely at my own risk and that the Macular Society shall not be liable for any injury or loss that might occur as a result of my participation*

Why have you decided to support the Macular Society?

Would you be happy for our communications team to contact you about your event? Yes No

Tell us you have a place

Charity event own place registration

We would love to stay in touch

Please let us know if you're also happy for us to contact you by email and text.