Register Your Support

Please register your support for the Proud2Bpat Campaign by registering below. You will be asked to confirm if you are a genuine Patrick or Patricia (or other variations of the name) or a Wannabe Patrick.

For Wannabe Patricks, why not consider becoming an honorary Patrick for the day and get sponsored to do so by using our deed poll partner. Find out more about it here, where you can also get a copy of the sponsorship form. Many people have already done so including our very own Patrick (formerly Paul) Rankin.

Already a Pat?

Or Wannabe Patrick?

Name
e-mail address
Location (town/city)
Telephone (optional)

Are you planning to attend the World Record Attempt in Trafalgar Square on 16th March?

Yes   No

	I would like to receive e-mail updates from Irwin's/Rankin
	I have read and understood the weekend draw terms and conditions

Security Validation Starting with the RED letter, reading clockwise, please enter all of the letters, in order, into the box below. *

SUPPORTED BY

© 2007 Great Ormond Street Hospital Children's Charity. Reg. Charity No.235825

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