Carers Rights Day (2024)

Carers Rights Day 2024

Carmarthenshire - Burns Centre - 20th November
Please complete this form for each carer who wishes to attend.
Are you an unpaid carer?

YesNo
Do you live in Carmarthenshire?

YesNo
Does the person you care for live in Carmarthenshire?

YesNo
This event is only available for someone who is:
- an unpaid carer living in Carmarthenshire
- an unpaid carer looking after someone who lives in Carmarthenshire

We are really pleased that you are interested in attending our event.

Please tell us a little about yourself.
What is your name?

First NameLast Name
Address

Street Address

Street Address Line 2

Town/CityCounty

Post Code
Phone Number
Email
example@example.com
Date of birth

DayMonthYear
Are you already registered with Carers Trust Crossroads West Wales (CTCWW)?

YesNo
Would you like to register and be added to our carers emailing list to continue receiving occasional future updates on carer events and services?

YesNo
Briefly summarise health needs and emergency medication we need to be aware of?
Please list any special dietary requirements
Emergency Contact Name

First NameLast Name
Emergency Contact Number
Please indicate if you require information on transport or replacement care
Do you require any support to access the event?

Carers Rights Day 2024