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You are here: Home / Get involved / Events and fundraising / Raise your Game for Dementia UK / Raise your Game registration form

Raise your Game registration form

Title
Name*
First name Surname
Where would you like your pack to be sent?
Organisation name (if applicable)
Address*
Street Address Address Line 2 City Postal Code
Email*
Phone number
Date of birth
Date Format: DD slash MM slash YYYY
What type of event are your holding?*
How did you hear about Raise your Game?*
If 'Other', please specifiy:
What inspired you to host Raise your Game?*
If 'Other', please specifiy:
We’d love to hear more about your Raise your Game event, so we can send you the right information. Let us know your plans now or get in touch at a later date.*
- Let us know now
- Tell us at a later date
When are you holding your event?
Date Format: MM slash DD slash YYYY
How many players are you expecting?
- 0-5
- 6-10
- 11-15
- 16-20
- 20+
Do you have a fundraising target?
If yes, please specify the amount you hope to raise below
Please enter a number greater than or equal to 1.
Keeping you updated
We will send you a fundraising pack in the post and email/SMS updates about Raise your Game. We would also like to keep in touch and update you with the latest behind the scenes news, including the incredible difference our specialist Admiral Nurses make, and how you can help us to continue our long term work by fundraising and volunteering for us.
- Yes, I’d like to receive email updates
- Yes, I’d be happy to receive updates by phone
- Yes, I’d like to receive text message updates
- No contact via post please
If you would like to change how you are contacted by us, simply contact our Supporter Care team on 0300 365 5500 or email at supportercare@dementiauk.org.

For further information about how we protect and use your data please see our privacy policy at www.dementiauk.org/privacypolicy.
Email
This field is for validation purposes and should be left unchanged.

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London EC3N 1RE
Tel: 020 8036 5400 Tel: 020 8036 5400
E-mail: info@dementiauk.org

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© Dementia UK 2021. Dementia UK is a registered charity in England and Wales (1039404) and Scotland (SCO47429).
A company limited by guarantee and registered in England and Wales (02944156).
Registered address: 7th Floor, One Aldgate, London EC3N 1RE