EmailMeForm
Jump for Cancer - Register your interest
Please fill out this form to register your interest in Jump for Cancer 2018. The Cancer Society's fundraising team will be in touch soon to discuss your participation in the fundraiser. Thank you for helping us make a difference!
Name
*
First
Last
Email
*
Preferred Contact Phone Number
*
Ts & Cs
View the terms and conditions here
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Participant Acceptance
*
If I am selected to participate in Jump for Cancer 2018, I will raise a minimum of $800 for the Cancer Society in exchange for a skydive with Skydive Taupo.
I confirm that I am happy to be contacted by the Waikato/Bay of Plenty Cancer Society.