Kick For A Cure Euro Cup Pool

After completing the below form you'll be prompted to select your Euro Cup teams and players.

Note: If you are entering as part of an organization or in support of a Kick For A Cure participant click here to select them.

Donation / Gift

Minimum $25.00

Your Name *

Email *

Payment confirmation will be sent to this email address.

Phone # *

Billing Address *

City *

Province / Region *

Postal Code *

Country *

Card Type:

Name on Card: *

Card #: *

Expiry: *

Card Verification Code: *

What is it?

Name on Tax Receipt: *

What name or organization do you want to appear on the tax receipt?

Display my name as a donor

Receive updates on childhood cancer research progress and Michael Cuccione Foundation events

Security Code *

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The Participant You are Supporting:

Gareth Williams

$0.00

$50.00

100%

Rasied so far: $50.00