Age Verification

Please enter your date of birth

(Please note you must be 16 or over to play)

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You must be at least 16 years of age to participate in this Raffle
Member Details

Your Details


Your Address


Raffle Details

Your Preferences

Your address, phone number and email address details are required for administrative purposes. We would also like to send you information about Moorfields Eye Charity's other fundraising activities. Please can you confirm whether you would like to receive this information below:


Would you like to receive raffle tickets in the future?

Your Tickets


Christmas Raffle 2019

Closing Date: 13/12/2019
Draw Date: 20/12/2019

How many tickets would you like?


🎫

Include a donation with your entry:


£

Add 25p to every £1 you donate – at no extra cost to you. I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I have given.

 


Date: 07/12/2019

Please notify us if you change your name or home address, or no longer pay sufficient tax on your income and/or capital gains, or want to cancel this declaration.

 
Tickets:  £ £
Donation: £

Total: £