Daisy Day Tickets - St Elizabeth Hospice

Dedicate a Daisy

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Your name*

Prefix First Last

Address*

Street Address Address Line 2 City County Postcode

Email*

Phone*

How many daisies would you like to dedicate?*

Who are you remembering?

First Last

Second dedication

First Last

How much would you like to donate to the hospice for Daisy Day?

£12 could fund 5 bereavement packs to help families to manage their grief

£25 could pay for clinical support & advice via our 24 hour helpline, OneCall

£30 could pay for a nurse's uniform

Other amount

If you would like to donate a different amount, please enter it below:

Boost your donation by 25p of Gift Aid for every £1 you donate.

Tick below as appropriate to make your declaration.

If I have ticked the box, I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want St Elizabeth Hospice to reclaim tax on the donation given. I understand that if I pay less Income Tax / or Capital Gains tax in the current year than the amount of Gift Aid claimed on all of my donations it is my responsibility to pay any difference. I understand St Elizabeth Hospice will reclaim 25p of tax on every £1 that I have given.

I am unable to give Gift Aid

How many free tickets would you like to book for Daisy Day on Sunday 4 September 2022?

6 maximum

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Dedicate a Daisy

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