Registration

Registration

M-Walk 2010 Registration

* - required

First Name: *

Last Name: *

Address: *

Suburb:

City: *

Postcode:

Email: *

Phone: *

Mobile:

Church Affiliation:

I would like to register for: *

I would like to set up an online fundraising page: * Yes No

You will need to set up a password to create a fundraising page:

Password: *
Confirm Password: *
My fundraising goal: *	$
Message to appear on my Fundraising page: *	Thanks for visiting my fundraising page. I'll do all the hard work and complete this event, but I would really love you to partner with us and help raise funds for the Mercy Ministries Home in NZ. Please make a donation by filling out the "Sponsor Me" form. It's simple, fast and totally secure and what you donate goes directly to the trust account of Mercy Ministries. Donations over $5.00 are tax deductible and a receipt will be issued (for NZ residents). So please sponsor me now! Many thanks for your support.
I would also like a sponsorship booklet sent to me

Thanks, we will send you a sponsorship booklet in the post.

Event Registration Fee: $15.00

Payment Method: *

By Cheque By Credit Card

If you have already paid, please enter your reference here:

I would like to receive updates from Mercy Ministries

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