Forename (required)

Surname (required)

Your Email (required)

Telephone

How did you hear about this event? (required)
—Please choose an option—BillboardBus ShelterTVRadioPoster/FlyerFacebookInstagramTwitterLinkedInAd on GoogleNewspaper ArticleEmailParticipated beforeWord of MouthLetterFamily or friend who has used our servicesWebsiteOther

I would like to hear more about: (Please check one of the options below)

Care and Support Services

Fundraising

Both

None

We do not sell or swap your details with any third parties

Please confirm you have read and accepted our Privacy Policy

There will be photography and / or videography taken at the event to promote this event in the future promotional use via advertising, PR to local and national media outlets, digital / online adverts, our social media platforms, and our website www.cancerfocusni.org. Should you wish to be excluded from any event photos or video, please email fundraising@cancerfocusni.org.