Sign up to Game Over Dementia with Tiltify

Thank you for choosing to be a part of Game Over Dementia. We’d really like to know a little more about you and the reason for your stream. This form should only take 5-10 minutes to fill out. Once completed, we’ll direct you to the dedicated Alzheimer’s Society Tiltify page where you can login or create an account and begin setting up your fundraiser event.

We ask for your details in order to contact you, keep you up-to-date and send further information.

To find out more about how we use your personal information, please read our supporter privacy statement.

Title (required)

First name (required)

Last name (required)

Email address (required)

Date of birth (required)

By clicking this box you confirm that you are over the age of 18 or have parental permission to take part (required)

Address line 1 (required)

Address line 2 (required)

Town / city (required)

Postcode (required)

Contact telephone number (required)

Please tell us the account username you will use on Tiltify: (required)

If you don't already have a Tiltify account, make sure this username is available and write this information down for when you're getting set up in Tiltify.

What date are you planning your Game Over Dementia event to start? (required)

If your event is happening over more than one day, what date will it end? (required)

Tell us more about your event. If you are taking on more than one event, please let us know each event name and date: (required)

I would like to raise (£) (required)

Occasionally we may offer merchandise linked to events. Please let us know your size preference for cotton T-shirts (only adult sizes are available).

Please select one of the options below.

Small cotton T-shirt (required)

Medium cotton T-shirt (required)

Large cotton T-shirt (required)

X-Large cotton T-shirt (required)

XX-Large cotton T-shirt (required)

We'll be in touch with information about your event soon.

We'd also love to talk to you about the amazing work we do with our services and research, and how you can do more to help with fundraising, campaigning, or volunteering in the future. You can update this at any time and we'll never sell your details to third parties.

If we can't reach out to you for help when we need it most, our work can't continue - so please, choose to stay in touch using the boxes below and help us beat dementia.

Yes, I'd like to receive exciting updates by email (required)

Yes, I'd be happy to speak to someone on the phone (required)

Yes, I'd like to hear breaking news via SMS (required)

Yes, I'm happy to receive updates through social media (required)

Please do not contact me by post (required)

Sign up to Game Over Dementia with Tiltify

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