Saint Michael's Care for a Cuppa 2019

Please complete the following details so that we can register your Care for a Cuppa event and send you your free participation pack containing everything you need to host your event.

First Name *

Last Name *

Date of Birth * +

Address *

Address 2

City *

Postcode *

Phone

Email Address *

I would prefer my pack sent by *

Email

Post

Your information will be used by Saint Michael's Hospice to provide you with the best service possible. Your details are safe with us. We will not sell or swap them. We will only use them in accordance with our information notice This does not affect your marketing preferences which can be updated at the end of this form.

Staying in touch

Thank you so much for being part of Saint Michael's Care for a Cuppa - your support will make a huge difference to people living with terminal illness. Saint Michael's Hospice would like to keep you up to date about our work, fundraising activities and ways to get involved.

Emails and SMS are quick and cost effective. Please let us know if you are happy for us to stay in touch in these ways.

Email

Yes please, I’d like to hear from you by email

No thank you, I don’t wish to hear from you by email

Text message

Yes please, I’d like to hear from you by text message or MMS

No thank you, I don’t wish to hear from you by text message or MMS

Mail and telephone are also important ways we can communicate with you. Please tell us if you would rather we didn’t contact you in these ways.

No thanks, please don’t contact me by post

No thanks, please don’t contact me by telephone

You can update your preferences or unsubscribe from marketing at any time by calling us on (01423) 878 628 or emailing supportercare@saintmichaelshospice.org

By submitting this form you confirm that the above details are correct, you have read and accept the information notice.

Please let us know how you heard about Saint Michael's Care for a Cuppa

*

Harrogate District Hospice Care is a registered charity in England and Wales (518905) with a family of services operating as Herriot Hospice Homecare, Just 'B', Saint Michael's Hospice and Talking Spaces.

Harrogate District Hospice Care is a company limited by guarantee, registered in England and Wales (2121179). Registered address Crimple House, Hornbeam Park Avenue, Harrogate, HG2 8QL.