Dip a Day in May
Take part as:
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Individual
Team
First Name
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Surname
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Email
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Phone Number
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Address
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Street Address
Address Line 2
City
State / Province / Region
Eircode
T-Shirt Size
If you would like a t-shirt, please let us know your t-shirt size. Please note, t-shirts will be provided to anyone who has set up their fundraising page.
S
M
L
XL
XXL
No T-shirt
How did you hear about the event?
Social media
Email
Outdoor advertising
Friends / Family
Galway Simon Website
Radio
Newspaper
From my company
From my club/school
Other
Join Team:
Select a Team
Select a Team
-or-
Create A New Team
Create A New Team
Would you like your team members to have individual fundraising pages (connected to team page), or would you rather use one collective fundraising page for all members?
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Individual Pages per Team Member
Single Collective Page
Team Name
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What type of team are you?
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What type of team are you?
Family
Friends
Work colleagues
School
Community group
Sports club
Other
After the event, we would love to send you updates about the difference your support makes and our upcoming events. Please choose how you would like us to communicate with you:
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Email
Phone
SMS
Post
I do not wish to be contacted
Agree T&C's
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I accept the
Terms & Conditions
By providing your contact details you are consenting to be contacted in relation to this initiative.
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By providing your contact details you are consenting to be contacted in relation to this initiative.
