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Registrant Form - Do it in the Dark 2021 Fundraiser
Date: March & April 2021

Organised by: Retina Australia

Phone: 1800 999 870 or (03) 9560 5088


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Email *
Full Name *
Phone Number *
Date of Birth
What mailing address should we send your Fundraising Kit to? *
When do you expect to run your event? *
What type of event do you plan to host? *
Will your event be run from home, at the workplace or virtually? *
What is the address of where you will host your proposed event? *
Will you create a 'Just Giving' supporter page? *
How many people will attend your event approximately? *
By registering for the Do it in the Dark 2021 fundraising event, I have read the relevant resources on the Retina Australia website detailing the fundraiser and understand the conditions of hosting an event for the organisation.   *
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