Fundraiser Registration | National MSA Research & Move4MSA

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How would you like to fundraise?* This field is required.Please select the type of fundraiser you’re planning or have already planned: Move4MSA – An individual or community movement-based fundraiser, such as walking, running, swimming, dancing, cycling, or another physical activity. General Fundraiser – A community or social fundraising event, such as a trivia night, gala, bingo night, or another creative fundraising activity.
Move4MSA
General Fundraiser
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Name* This field is required.
First Name
Last Name
3
Name* This field is required.
First Name
Last Name
4
Email* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
6
Which Move4MSA Events* This field is required.
A Walk to Remember
Create your own
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How will you take part in A Walk to Remember?* This field is required.Choose Community Walk to attend an organised walk, or Walk Your Way to complete your own walk. We will email you with the relevant next steps.
Community Walk
Walk your Way
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How will you participate in Move4MSA?* This field is required.
Individual
Team
Community group
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What type of fundraiser are you planning or have planned* This field is required.
Please Select
Trivia Night
Gala Night
Crowd Funding
Sausage Sizzle
Morning Tea
Other
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Other fundraiserOnly complete this if you selected Other.
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Description/Notes of fundraiser* This field is required.
Tell us a little about your fundraiser or event details.
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File UploadPlease upload any information of your fundraiser, IE Plans, Supporting Documents,
Drag and drop files here
Select files to upload
Cancelof
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What is the proposed date of the fundraiser?
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Which state or territory will your fundraiser take place in?* This field is required.
Please Select
Please Select
Victoria
New South Wales
Queensland
South Australia
Western Australia
Northern Territory
Tasmania
Australian Capital Territory (ACT)
15
Please read the Terms and Conditions.

Move4MSA - A Walk to Remember
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Please read the Terms and Conditions.

Community Fundraiser
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Please read the Terms and Conditions.

Move4MSA - Create your own event
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Participant full name* This field is required.
First Name
Last Name
19
Date of Birth* This field is required.DOB of the Participant
Date
Day
Month
Year
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Email (Participant)* This field is required.Email address of the participant.
example@example.com
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Is the Participant over 18* This field is required.
YESNO
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Parent or Guardian Full Name* This field is required.
First Name
Last Name
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Email (Parent/Guardian)* This field is required.Email address of the parent/guardian.
example@example.com
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Phone Number (Parent/Guardian)* This field is required.
Please enter a valid phone number.
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Move4MSA Consent* This field is required.
I confirm that I have read and agree to the Move4MSA Terms and Conditions. I understand the physical nature and ordinary risks of participating and confirm that I am able to participate safely. If I am registering a participant under 18 years of age, I confirm that I am their parent or legal guardian and consent to their participation.
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Photography and recordings permissionFor children, this optional permission must be given by a parent or legal guardian.
I consent to Move4MSA/National MSA Research using photographs or recordings of me, or the child I am registering, for awareness, fundraising, reporting and promotional purposes.
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Community Fundraising Consent* This field is required.
I have read and understood these Community Fundraising Terms & Conditions.
I agree to comply with all applicable laws and regulations.
I understand that I am organising this fundraising activity independently and not as an employee or representative of National MSA Research.
I agree to remit all funds raised to National MSA Research within 30 days of the completion of the fundraising activity.
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Please verify that you are human* This field is required.
Should be Empty:

Please read the Terms and Conditions.

Move4MSA - A Walk to Remember

Please read the Terms and Conditions.

Community Fundraiser

Please read the Terms and Conditions.

Move4MSA - Create your own event