Jolly Jumper Day Sign-Up

Thank you for taking part in Jolly Jumper Day. Please complete the short form below to register your fundraising with us.

We have lots of fabulous promotional materials available. Please let a member of the team know what you need, when they contact you, to help make your event a success.

Your Fundraising

Date of event (required)

How much do you hope to raise? (required)

Please use the below to tell us about any additional information relate to your fundraising.

Registering (required)

Name of company/organisation/school/college/university

Your Details

Title (required)

First name (required)

Surname (required)

Address Line 1 (required)

Address Line 2

City/Town (required)

Postcode (required)

Email Address (required)

Main Phone Number (required)

Date of Birth (required)

If you have a Facebook (@BirminghamChildrensHospital), Instagram or Twitter (@Bham_Childrens) account that you will be using for Jolly Jumper Day, we would love for you to use the hashtag #JollyJumperDay and tag us using our handles, so we can share your post.

Birmingham Children’s Hospital Charity is committed to protecting your data, and we will never sell our supporter’s data to third parties. By providing us with any personal information you consent to the terms and conditions of our Privacy Policy available at www.bch.org.uk.

If you want to change the way we keep you informed about our work, you can do so at any time by speaking to our Supporter Care team by phone 0121 333 8506 or by email [email protected].

We’d love to keep you informed about our work, and the exciting ways you can support us in the future (required)

Please tick if you’re happy to hear from us by emailPlease tick if you’re happy to hear from us by SMSPlease tick if you’d prefer NOT to hear from us by postPlease tick if you’d prefer NOT to hear from us by phone

Declaration (required)

I agree to donate all the proceeds from the Jolly Jumper Day to Birmingham Children’s Hospital Charity. Under no circumstances will I divert any money raised in this name to any other organisation or individual, without the full knowledge and consent of Birmingham Children’s Hospital CharityBy ticking this box I understand and agree that Birmingham Children’s Hospital Charity does not accept any responsibility for this event or activity. I understand and agree that I am undertaking this event or activity at my own risk and that Birmingham Children’s Hospital Charity is not responsible for any risk, injury, loss or damage that may result and will not be liable for any claim which may arise

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