Title*MrMissMrsMsDrProfOtherFirst name*Surname*Address*Postcode*Telephone number*Date of birth* DD MM YYYY Anyone can take part in Raise Your Game, however if you are under the age of 18 we will need parental/guardian consent. If this is the case please provide your parent/guardian’s email address below. Email address* I am happy for Birmingham St Mary’s Hospice to contact me via email about.... Fundraising appeals Competitions Events Volunteer opportunities Section BreakAbout your Raise Your Game challengeWhat Raise Your Game challenge will you compete in? Video gaming Board gaming What date will you take part in Raise Your Game? Date Format: MM slash DD slash YYYY Please provide a link to your Twitch Channel if you will be streaming on Twitch.Would you be happy for us to stream your Twitch Channel on the Birmingham St Mary’s Hospice Twitch Channel?YesNoLink to your Twitter page if you will be streaming online.Why have you chosen to take part in Raise Your Game?How did you hear about Raise Your Game?Leaflet/PosterNewsletterSocial mediaHospice websiteOther websiteWord of mouthOtherSection BreakDeclarationsWe will process your personal data in our database. We will use this information for planning and administrative purposes and may also, from time to time contact you by post or telephone about our work and to raise funds using appeals, competitions or events. If you would prefer not to receive the type of information outlined above, you can opt-out at any time by calling 0121 472 1191 or by ticking the box.