Alzheimer's Association : Register

Create Account
Create Your Fundraising Page
Optional Donation

Joining Team Feri Test Team 02

I'd rather just register as an individual

Joining Organisation SS Team

I'd rather just register as an individual

Create Account
Already have an Account

Personal Details

First Name *

Last Name *

Email Address *

Yes, I would like to receive email from the Alzheimer’s Association.

Password*

Mobile

This event requires providing a valid phone number to register. We will only use this number to contact you in case of an emergency or weather alert. By registering, you are agreeing to be so contacted.

Would you like to receive updates and alerts about this event and the fight to end Alzheimer's?

Yes, text me at the number provided above.No, I do not wish to receive text messages.

If you choose to opt in to text messaging from the Alzheimer's Association, you will be able to opt-out of these messages at any time by texting STOP. Msg & data rates may apply. No consent required to buy. Privacy Policy applies.

Dietary Requirements

Postal Address

(enter manually)

Address Line 1

Address Line 2

City

Zipcode

State

Country

Emergency Contact Details

Please provide us with an emergency contact

First Name

Last Name

Contact Number

Relationship to you

Medical Conditions

Do you have any pre-existing medical conditions which might affect your ability to take part, or be relevant if treatment is needed?

Yes No

Terms & Conditions

I agree to the above Terms & Conditions *

Feri Test SS

Raised

$650

My Goal

$500