Gift Registration Form - St Cuthbert's Hospice

Welcome to St Cuthbert’s Hospice Win Win Lottery. We hope that you are delighted with your Lottery Gift.

The Lottery Department requires this form to be completed in full to ensure that the Lottery Number purchased as a Gift is registered to the Gift Recipient before entry into Lottery draws.

Unless this form is completed and submitted, any winnings attributed to the Lottery Number purchased will be paid to the original purchaser of the Gift as St Cuthbert’s Hospice will not have sufficient details to pay you, the Gift Recipient.

Purchaser's First name*

Purchaser's Last name*

Your First name*

Your Last name*

Full Home Address

Your Postcode*

Date of Birth*

Email Address*

Telephone

Consent to pay

I confirm that I am over 16 years old and a resident of Great Britain tick the box

Keep in Touch

From time to time we would like to send you information about our news and activities. We will only use your information for the purpose it was collected, or for similar/related purposes. Your information will be handled in accordance with our Data Protection Policy. You can update your preferences at any time by contacting our Database Administrator on 0191 374 6166. Please tick to give consent to receive these by:

EmailSMSIf you would prefer NOT to receive information by POST please tick here

Gamble Responsibly

If you want to have a break from gambling you can use our self-exclusion option. Call us on 0191 374 6176 or email hello@stcuthbertshospice.com.

If you need to talk to someone about problem gambling then contact GamCare Telephone 0845 6000 133 (UK local rate) www.gamcare.org.uk

Players must be aged 18 years or over to play the Lottery or claim a prize.

Terms & Conditions apply.