Membership Form | The Ryan MS Therapy Centre

Name *

First

Last

Address

Address Line 1

City

State / Province / Region

Postal Code

Contact Telephone Number *

Email *

Please confirm that you would like to become a member of The Ryan MS Therapy Centre having read the terms of membership. *

I confirm

Are you happy to receive marketing communications from the charity and understand that your details will be retained for this purpose only and not passed to any third party? *

Yes
No

Do you have multiple sclerosis (MS)? *

Yes
No

Do you currently attend The Ryan MS Therapy Centre for physio? *

Yes
No

Would you like to/ be able to attend The Ryan MS Therapy Centre regularly for physio? *

Yes
No

The Ryan MS Therapy Centre is 100% reliant on donations to continue its work. Would you like to make a donation to assist our work? *

I would like to make a donation to the charity
Not just now

As a charity that is 100% dependant on donations, we are keen to make use of the government’s Gift Aid scheme whenever we can. This will boost any relevant donation by 25% at no additional cost to you. If you pay UK Income and/or Capital Gains Tax, please allow us to claim Gift Aid on your donations. *

I confirm that I am a UK taxpayer and would be happy for The Ryan MS Therapy Centre to claim Gift Aid on any donations I make to them either now or in the future. I understand I may cancel this declaration at any time by contacting the charity directly.
I am not a UK taxpayer or do not want my donations to be considered for Gift Aid for another reason

ComeJoin Us

Membership of the Ryan MS Therapy Centre

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