Choose your number of entries *

* = Required field

Every entry costs £1.00 a week.

1. entry per week – £4.34 per month
2. entries per week – £8.68 per month
3. entries per week – £13.02 per month

Your personal details

Title *

First name *

Surname *

Email address *

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Home/landline telephone number

Mobile telephone number

Enter your postcode including any spaces

Tick here to enter your address manually

Address 1 *

Address 2

Address 3

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Postcode *

Contact Preferences

We'd love to stay in touch. We couldn't do any of our life-changing work without you. We'd like to keep you up to date about news, fundraising campaigns and events and what you are helping to achieve.

If you'd like to receive information in the following ways, please tick accordingly:

Email: Yes

Phone: Yes

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Terms and Conditions *

I have read and agree to the Terms and Conditions and Privacy Policy of this service.

Please enter your Date of Birth *

Over 18 You must be at least 18 years or older to enter

Where did you hear about our lottery? *

Please choose where you would like your support to go

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