Spinal Research Hero Month 2022

Register as a practice, organisation or business for Spinal Research Hero Month.

This registration is for those practices, organisations or businesses who are doing fundraising activities of their own.
This is NOT the registration form for the Health & Wellness Challenge.

Please have a logo or photo of your team ready to upload before you begin this form.

Name*
Prefix First Last
Practice / Company Name*
Email*
About your fundraising activity/s*
Please let us know a little about your fundraising activity, including the type of activity and your fundraising goal (if you have one). Eg: "A Superhero dress up day for staff and patients on March 6th. $300 fundraising goal". (200 characters max)
Do you want us to send you a receipt book(s)?*
Donations of over $2 are tax deductible in Australia. We can provide you with receipts if you are intending to gather donations in person. Please include your postal address below if you want receipt book(s). Contact us if you require more than 3 books (ie: more than 150 receipts total). Allow up to 2 weeks for delivery.
- No thanks.
- Yes, please send 1 book of 50 receipts
- Yes, please send 2 books of 50 receipts (100 receipts total)
- Yes, please send 3 books of 50 receipts (150 receipts total)
Postal Address
ONLY required if you want receipt books.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please upload a photo of you or your team OR your logo.
This will be displayed on our fundraising page, to show people who is fundraising for us and what they are doing. It's a great way to inspire others! If using a logo, one with a transparent background would be great if you have it. Thanks.
Accepted file types: jpg, gif, png, Max. file size: 2 MB.
Link for web page
If you'd like your photo or logo to link to your webpage or social media, please include a link below.
After submitting this form you will be emailed a kit with more detailed information.