Fundraiser Registration

Register to raise funds to support childhood cancer research through your very own fundraising wall / web page. Once we review and approve your registration, you will be able to upload your photo and manage your fundraising campaign.

Account Details

Fundraiser's Name or Campaign Title *

Email * It will be your login username to manage your fundraising campaign page.

Do you want to show your email address on your campaign page? When we display email addresses, we encode them to prevent spamming robots from capturing them, so it is safe. When shown, people can contact you directly.

Password *

Phone

Do you want to show your phone # on your campaign page?

Mailing Address

Address * Not shown anywhere on our website. Used for internal administration purposes only.

City *

Province / Region *

Postal / Zip Code *

Country *

Your Social Media Profile

Do you have a website? Please enter your full website address.

What is your Facebook address? Please enter your full Facebook page address.

What is your Twitter address? Please enter your full Twitter address.

Fundraising Campaign Details

Fundraising Purpose

How much are you aiming to raise? *

Fundraising Campaign Description *

Additional Detail