Fundraising Registration Form

  • Personal Details
  • Person to contact who is coordinating the event or activity
  • Event Details
  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Please be as detailed as possible.
    Please specify if you agree to allow QEI to promote or publish details of your event.
    I agree to act in a professional manner in conducting the fundraising activity and uphold the integrity and values of the Queensland Eye Institute. I also accept my obligation to remit the funds raised to the Queensland Eye Institute within 14 days of the event conclusion. You will be contacted by a fundraising team member with the full terms and conditions for fundraising on behalf of QEI. Prior to publicising or conducting any event you must obtain Queensland Eye Institute's approval.

For the health and safety of our patients, staff and visitors, we ask you do not enter the QEI South Brisbane or QEI Clayfield facilities if you:

  • Have been in contact with a known case of COVID-19 
  • Have recently travelled overseas or interstate and have NOT undergone a two week quarantine 
  • Are awaiting COVID-19 test results
  • Have cold or fever symptoms (sore throat, coughing, sneezing etc)
  • Recently visited a COVID-19 hot spot (as identified on the Queensland Government website)

Please note that all visitors at this time will undergo contactless temperature checking. Our staff will also require the full names and contact details of all visitors to the building. 

Thank you for your cooperation at this time, please don't hesitate to contact us on 07 3239 5000 if you have any concerns.