Online Signup - Lottery - St Elizabeth Hospice

Thank you for signing up to our Lottery. Please fill in the form below to sign up.

Please note - as of 14 April 2020, we are unable to process credit card payments for our lottery. Please only sign up using a debit card, otherwise your sign up will not be successful.

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Title*
First Name*
Last Name*
Address*
Street Address* Address Line 2 City* County* Postcode*
By ticking this box, I confirm I am over 16 years old.*
- I am over 16
Date of birth*
DD slash MM slash YYYY
Phone*
Email*
Enter Email* Confirm Email*
Are you joining in memory of someone?
Are you signing up for the first time or renewing your membership?
If yes, state name:
First name*
Last name*
Terms and Conditions*
- I agree to the Terms and Conditions
Contact preferences
We would like to stay in touch with you to let you know how your support makes a difference, and other ways you can get involved. We will hold your personal information in accordance with the Data Protection Act 1998 and we will not pass on your personal information to third parties.
- Please send me mail
- Phone calls are ok
- Please send me email
- Please send SMS (text)
Please enter your lucky draw number(s) if known
How many chances per week?*
Select payment frequency*
Keep the change?
Please consider making an additional donation to round your payment up to the nearest £5 or £10.
Total
£ 0.00
Refund policy
It is the policy of St Elizabeth Hospice Lottery to not give refunds once the payment has been processed onto the lottery software. If when a lottery number is cancelled and there is less than £1 credit on the lucky draw number, St Elizabeth Hospice will treat this amount as a donation to hospice funds.

St Elizabeth Hospice is licensed and regulated in Great Britain by the Gambling Commission under account number 5049 https://registers.gamblingcommission.gov.uk/5049

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