Registration

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Thank you for joining the

2018 Walk for Love

This year there will be no registration fee.

While our Walk for Love is an important fundraiser for Mary Potter Care, it is very much about honouring the lives, courage and memories of our loved ones.

In order to be part of the Walk, we ask that you make a gift from your heart.

Your donation will help to ensure that each patient and their family receive care that is individual, meaningful, compassionate and loving.

What better gift than to make patients and families feel loved in their final days and weeks together.

Once you register, an online fundraising page will be automatically generated for you. If you do not wish to fundraise online then please untick the box on the next page so that your page will not be searchable.

You will have the option to add and register more family members and friends on the next page.

Search for a team to join.

Team Name
(Contains)
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Captain's First Name
(Contains)
Captain's Last Name
(Contains)

You must search for a team to join. You must enter something in at least one of the 3 fields above.

* Please select a team to join. Use this search to find the team you want to join. * No teams matched your criteria. You must search again with new criteria to find a team to join.

	Team Name	Captain Name

* Select your team type

	Team Type	Fee	Description	Full Description

Create Your Team

You will become the team captain and will be able to recruit others to join your team.

* Denotes required information.

* Team Name
Team Description
Team Fundraising Goal
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Corporate Team Affiliation

If you are affiliated with a corporate team, select the corporate team from list below

Permission Questions I would like my page to be searchable on this website so that my friends and family can search and donate to my fundraising.

Additional Questions

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Your contact details

* Denotes required information.

Name

Title
* First Name
* Last Name

Address

Home Work
Company Name
Enter address manually
* Country
* Address
Apartment
* Suburb/Town
* Province
* State
* State
* Province/State
* Postcode
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Phone Number ( )
Area code is invalid. Phone number is invalid.
Mobile Number ( )
Area code is invalid. Mobile number is invalid.
* Email Address
Email address is invalid.
* Confirm Email
Email addresses do not match.

Emergency Contact

Please provide a contact in case of emergency.
Full Name
Phone Number 1 ( )
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Account Information

Your account username and password will allow you to login following registration.
* Username
This username already exists.
* Password
* Confirm Password
The passwords do not match.

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Would you like to buy some t-shirts?

T-shirt orders will be available for collection from the registration desk at the Walk for Love this Sunday 21 May.

Please note a handling fee of $11 has been automatically added to your shopping cart. This amount can be receipted as a tax deductible donation or can be refunded to you. Please call us on 08 8239 0119. We are sorry for this inconvenience.

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Shipping Information Shipping address is the same as my registration address

* Denotes required information.
Home Work
* Country
Shipping Name
* Address
Apartment
* City
* Province
* State
* State
* Province/State
* Postal Code/Zip Code
Postal code or zip code is invalid.

Price:

Quantity:

Items in your cart

Registration Fee

Price:

Donation Amount

Total:

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Your payment details

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Payment

Did you know that by covering the processing fee, Mary Potter Foundation will be able to help more people?
I want to cover the fees ( %ProcessingFee% )

Your credit card will be billed for the following amount:
Each participant agrees to raise %FundraisingMinimum% for this event. You have authorized Mary Potter Foundation to charge your credit card in the event that the minimum fundraising amount is not met.

At this time, your credit card will not be charged.
Each participant agrees to raise %FundraisingMinimum% for this event. You have authorized Mary Potter Foundation to charge your credit card in the event that the minimum fundraising amount is not met.

Your credit card will be billed now for the following amount:

Registration Fee:
Donation:
Coupon:

Processing Fee:

Total:

Pay using PayPal
Pay using a Credit Card
* Credit Card Type:
* Credit Card Number:
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* Card Security Number: (?)
* Card Holder Name:
* Expiry Month:
* Expiry Year:
Valid From Month:
Required if Valid from Year is set
Valid From Year:
Required if Valid from Month is set

Issue Number:
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Confirmation

Please check that the details below are correct and click on previous to make any changes.
If you are happy with your details, please click Next.

Please check that the details below are correct or click on Previous to make any changes.
If you are happy with your details, please click Next and your payment will be processed.

Name:

Address:

Email:

Credit Card:

***-

Credit Card Expiry Date:

Card Holder Name:

Total:

Security Check

We have implemented an extra step in order to prevent Credit Card fraud. Unfortunately, some people use automated programs to test whether fraudulently obtained credit cards are valid. To counteract this practice we ask that you answer the question below.

* I accept the waiver. Please accept the waiver.

* I accept the waiver on behalf of the other participants I have registered. Please accept the waiver.

* Sorry, username %loginName% is in use. Please try another one.

The credit card payment failed.

Please answer the security question.

* Sorry, page alias %pageAlias% is in use. Please try another one. Sorry, team page alias %pageAlias% is in use. Please try another one.

Sorry - team %teamName% is full.

Sorry - start time %starttime% is full.

Please switch to the payment window to process your payment.

Your payment cannot be completed because your browser blocked the payment window pop-up.
If you are using IE (Internet Explorer from Microsoft), do not use the option near the top of the page (under the toolbars where it says "Pop-up blocked. To see ...") to disable the blocker. Instead, use the "Ctrl+Alt" option. That is, close this message window, and try clicking the register button again, but hold down both the "Ctrl" key and the "Alt" key before clicking the button. Keep the "Ctrl" and "Alt" key held down until the paymentwindow appears.
Another option is to try a different payment method.

You are already registered for this event.

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Address Validation

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I will walk the following distance

Terms & Conditions

Thank you for joining the

2018 Walk for Love

Create Your Team

Your contact details

Donate and Register

Add another

Your payment details

Confirmation

Confirmation

Address Validation

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I will walk the following distance

Terms & Conditions

Thank you for joining the 2018 Walk for Love

Create Your Team

Your contact details

Donate and Register

Add another

Your payment details

Confirmation

Confirmation

Address Validation

Thank you for joining the

2018 Walk for Love