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Registration - Personal Details

You have elected to join team: Brookfield Multiplex

If you have already registered for the event, please log into your personal account and elect to 'join a team'.

To be part of a team, you must enter as an individual first.

At the end of this registration process, an individual fundraising page will be created in your name and will be available for you to personalise. This unique online fundraising tool will make it easier to keep track of your sponsorship progress, promote your fundraising and thank your sponsors.

Required fields are marked with an *

Personal Details

Have you participated in an MS event before? * yes no

Title *

First Name *

Last Name *

Gender *

Date of Birth * / /

Postal Address

Address line 1 *

Address line 2

Town/suburb *

Postcode *

State *

Contact Details

Home

Work

Mobile

Email Address *

Account Details

Create Username *

Hint: Simply enter your first and last name
Team captains: Do not put your team name here.

Password *

Confirm Password *

Personal Donation

Kickstart your fundraising by sponsoring yourself. Your personal donation will be included on your fundraising web page.

$30 - MS Info Pack & DVD for those newly diagnosed

$70 - Hand rail installed in a person's home to assist with stairs, as MS can affect balance

$120 - Installation of a Shower Chair in someone's home

$265 - 1 night's stay at Granston Lodge - residential accommodation for people with MS

$500 - A professional Health & Lifestyle assessment for a person with MS

$ other amount

* Please note all donations are tax deductible - an automatic receipt will be issued by email.

Your Fundraising Page

The below fields will appear on your fundraising page

Fundraising goal $

Page Title

Message

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