Big Brum Bucket sign-up - Birmingham Hospice

Big Brum Bucket registration

First name(Required)

Surname(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of birth

Email address(Required)

Telephone number(Required)

Are you volunteering as(Required)

Please select which time and date you are available to volunteer:(Required)

Please select your preferred location(Required)

T-shirt size:(Required)

Emergency contact name(Required)

Emergency contact phone number(Required)

How did you hear about Big Brum Bucket?

Would you be happy to be a 'Head Bucketeer' for your location?

Yes

Is there anything else we need to know?

By signing up to this campaign, you are consenting to receiving ALL information about this campaign. We would ALSO like to keep in touch with you about our vital work and update you on our news and fundraising activities. Please tell us if you would be happy for us to contact you:

By email

By SMS

We may also contact you by telephone and/or post. If you wish not to be contacted by post or telephone please tick here:

Opt out of telephone

Opt out of post

Sign up to Big Brum Bucket

Big Brum Bucket registration