CHARGE Syndrome UK Conference 2018 Family Day - Leisure Club

Saturday 20 October, 10am to 4pm, at TouchBase Pears in Selly Oak, Birmingham

We are so pleased you can join us for the 2018 Leisure Club run by Sense, part of the CHARGE Family Support Group’s UK conference. To make sure we get the day just right for you please tell us about yourself.

To secure your place we need you to complete this information by Friday 31 August.

IMPORTANT: If you get an error message when you click Submit at the end of this form, please click the Back button on your browser and click Submit again. Don't worry, your answers will still be there.

All about me
My family contact details
Your family email address
Your family telephone
Your family address, including postcode
Before you continue
If yes, stop right here! You have recently told us lots of information about yourself. We will create your Leisure Club All About Me and send this to you to check information. Please scroll to the section of the form ‘To be completed by a parent / guardian’ and continue from there to secure your Leisure Club place. If no, please continue and complete the rest of the form.
Medical conditions
PLEASE NOTE. We will only be able to support you to take medication on the day if all medication is in its original packaging and in date. We will follow prescription instructions on the packet.
Emergency Contact (to be completed by Parent / Guardian)
Please include postcode
Please make sure you have provided the best phone number to contact you during the event.
Permissions (to be completed by parent / guardian)

Keep in touch

Your support is extremely important to us. We’ll use the details you’ve provided to let you know more about our work and other ways you can help, including how you can volunteer, make a donation, or support our campaigns.

Would you like to receive updates by email?

We would like to contact you by post, but if you don’t want to hear from us please contact Supporter Services