Registration step 1 of 2

I/We wish to sponsor lights (one name per light)

Your light will take a special place amongst the thousands shining on our tree throughout the festive season. To help you we have printed an example; so, if children make the donation for a parent, the form should be ﬁlled in as follows:

Full Name of person to be entered in the Book of Honour	Name of person/s making the donation
Mary Jane Brown (Example)	Paul & Rose Brown (Example)

Your donation will be acknowledged with a commemorative card showing the name of the person to whom your light is dedicated.

if you do not wish to receive a card please check this box

Your dedication will automatically be entered into our Book of Honour which is displayed in our Chapel, in The Warrington Guardian, and online at www.stroccos.org.uk.

if you do not wish your dedication to appear on our website please check this box

Light Up a Life pin badge

I would like to purchase the following number of Light Up a Life pin badges at a cost of £2 each:

I would like to make a donation to cover the postage of sending the badges of:

Your details

*All fields are required

Address

Contact Information

Keep in touch!

Would you like to receive emails about forthcoming fundraising activities and how your support helps patients and their families at St. Rocco’s? Yes
No

We might also occasionally send this information in the post. You can update your contact preferences at any time by emailing consent@stroccos.org.uk or phoning 01925 575780. We promise to respect your privacy and that the data we gather and hold is managed in accordance with the Data Protection Act 2018. For more information please see our Privacy Notice.

Your Donation

I would like to donate

£25

£40

£50

£100

Other £

Any dedications received after Thursday 26th November 2020 will be added to the Book of Honour after both the services.

You can now arrange for your dedication to be included automatically every year. Please call the Fundraising Department on 01925 575780 to set up a direct debit and ensure that your light shines each year in honour of your loved one.

Add Gift Aid to your donation

Boost your donation by 25p for every £1 you donate. Gift Aid is reclaimed by St Rocco's from the tax you pay for the current tax year.

Yes I want to Gift Aid my donation and any donations I make in the future or have made in the last 4 years to St. Rocco’s Hospice.

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of the Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

Please notify us if you change your name, address or tax status.