FASD Awareness Registration Form
Welcome to FASD Awareness we will process your enquiry ASAP
What service are you enquiring about?
Parent/Carer Support Groups
1-2-1 sessions
Activity Days
Adult FASD Friendship Group
Junior FASD Friendship Group
Neuro Cafe Drop-ins
Other
In which capacity is your interest in FASD?
Living with FASD
Birth Parent
Adoptive Parent
Foster Carer
Grandparent
SGO
Sibling
Carer
Professional
Other
Details
Please fill out your details below
Name
*
First Name
Last Name
Name of FASD Individual (If applicable).
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Do you or the person you support have a suspected/pending or confirmed FASD diagnosis?
*
Yes - Confirmed
Yes - Pending
Yes - Suspected
No
Other
Please provide a brief background on your relationship/journey with FASD*
Activity/Event Day Information (Required)
If registering for an event or activity day please fill out the information in this section
Names of Children attending plus their age.
Names of Adults attending.
Do you have a valid/in date Leeds Castle tickets
Yes
No
First time guest
Do you consent to video/photo being taken and used as part of our social media and promotion.
Yes
No
Other (please explain any restrictions)
Restrictions details
I confirm that I have read the event disclaimer.
Where did you hear about FASD Awareness?
Facebook
YouTube
LinkedIn
Twitter/X
Search Engine
Referral from professional
Networking
Email
Other
I would like to subscribe to the mailing list for information and updates
By submitting this form you are giving consent for FASD Awareness to retain this information inline with our Privacy Policy. We promise to keep your personal details safe. You can change how we contact you at any time by contacting us at info@fasdawareness.org.uk or 01634 566 323. To see how we protect and use your personal data read our PRIVACY & SAFEGUARDING policies on our website.
Thank you for contacting us.
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