Shave for a Cure NZ : Register

Joining Team F & J Coleman Family

First Name *

Last Name *

Email Address *

Password*

Phone *

I am over 16 years old *

Yes No

I'd like to hear how the money I raise is making a difference.

Yes No

(enter manually)

Address Line 1

Address Line 2

Town/Suburb

Postcode

Region

Country

How many years have you participated in Shave for a Cure? *

When is your Shave Date? *

I agree to the terms and conditions of Shave for a Cure and the privacy policy.*