Your Name *

If you are organising the event as part of a club, school, place of work, etc., please give details.

Phone *

Email *

Date of your event *

Tell us about your event (include location, timings and ticket prices if relevant) *

What type is your event? *

Have you been in touch with your local Branch of the Irish Kidney Association? *

You can find details of your local Branch here

Do you need any additional support from us? (t-shirts, posters etc.)

Website / URL (such as a JustGiving fundraiser page etc.)

Email *