We're sorry, but you must be over 16 to play the Hospice Lottery.
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Important Information
Please note that your initial entry into our next Lottery draw must be paid upfront by credit or debit card on the next page of this purchase form. Your second and all subsequent entires will be automatically collected by Direct Debit from your nominated bank account.
Your rights
Organisations using the Direct Debit Scheme go through a careful vetting process before they are authorised, and are closely monitored by the banking industry. The efficiency and security of Direct Debit is monitored and protected by your own bank or building society.
The Direct Debit Guarantee applies to all Direct Debits. It protects you in the rare event that there is an error in the payment of your Direct Debit. The Guarantee covers Direct Debit payments. It cannot be used to address contractual disputes between you and the billing organisation.
Direct Debit Guarantee
The Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
Your bank account details
Please do NOT state name of bank as 'Name of bank account holder' - this field is for the name of the person the account belongs to (e.g. Mr Joe Bloggs)
By selecting Next you confirm that you are the signatory of the account to be debited and that no other signature apart from your own is required to authorise the set up of this Direct Debit instruction.
Please note if you have selected to pay for tickets using Direct Debit, that your initial first entry into our next Lottery draw must be paid upfront by credit or debit card using the payment options below. Your second and all subsequent monthly entires will be then automatically collected by Direct Debit from your nominated bank account.
By selecting Proceed to Payment, you will be confirming that you:
Please click one of the PayPal options to complete payment and submit the form.