"*" indicates required fields 1Donation Details2Your Details3Donation Summary Help us make a meaningful differenceHow often would you like to donate?One-offMonthlyDonation Amount*Choose how much you would like to donate. £100 - One-off - can provide Music Therapy for a child receiving inpatient care on Clark Clinic this Christmas. £50 - One-off - can provide financial support to a family facing an extended stay in hospital this Christmas £25 - One-off - can provide sensory play equipment for a child receiving inpatient care on Clark Clinic this Christmas £15 - One-off - can provide gifts to a family in hospital over Christmas. £5 - One-off - can provide a teddy bear to a newborn baby diagnosed with heart disease. Other amount Other Amount What prompted your donation today?I or my immediate family has directly benefited from the charity's services.A friend or someone I know has benefited from the charity's servicesNo direct connection - I just wanted to support a great cause.Please provide the reason for your donationI wish to support your Christmas AppealI am paying in money from a fundraising event or collectionI am donating on behalf of a company / school / organizationI want to make a general donationI am donating in memoryIf your donation is in lieu of Christmas Card or Gifts, please specify if you would like to recieve our E-Card.Yes - I would like to receive an E-cardNo- Thank YouPlease provide more details about your donation here. This helps us better understand and acknowledge your support. Thank you.For example, if you are paying money in from a fundraising event please specify the event. If you are donating on behalf of a company/organisation or group, please provide their information here. Complete your details to make a donationWhat's your name?* First Last What's your email address?* Enter your address* Street Address Address Line 2 City County / State / Region Post code We'd love to stay in touch and keep you updated with our charity news and activities. Please let us know if it's okay to contact you. The Charity is committed to processing data in accordance with its responsibilities under the GDPR. You can view our privacy policy here I'm happy to be contacted by:* Email Phone Post Please don't contact me by email, phone or post for the purposes stated. Gift Aid your donation!*You can boost your donation by 25% at no extra cost to you. Yes, I want to add Gift AidI agree to Children's Heartbeat Trust claiming gift aid on this donation and any donations made in the future. I confirm this is a personal contribution and as a UK taxpayer understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on my donations, it is my personal responsibility to pay the difference. Children's Heartbeat Trust will reclaim £0.25 of Tax back for every £1 I donate. 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