Merry Miles 2021 Registration Form

£ Donation Amount:

Select Payment Method

Debit/Credit Card

Tell us about yourself

First Name *

Last Name

Email Address *

Number and Street Name

Town

Postcode

How are you taking part in the Merry Mile?

Team Name

Names and t-shirt requests

Please add the names and T-Shirt size for each participant

Names & Sizes

Participant Name	Participant T-Shirt Size	Actions

We would love to keep in touch with you!

Do you give permission for MCH Charity to contact you about appeals, fundraising activities and news. You can change your mind about receiving information from us at any time – just tell us.

Yes No

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Terms

Show Terms

Your Declaration

Donation Total: £10.00