Young Carers 4 - 17 Years - Holiday Hubs
Complete the fields below to register your interest in this event.
Young Carer Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email address
*
Please advise us of any medical conditions or dietary requirements that we should be aware of, and any medication taken, including dosage.
*
Please provide emergency contact details including full name and phone number. You can provide details for multiple people if you wish.
*
I hereby grant permission for Carers in Bedfordshire to capture my image/or my child’s image in photography or film and/or make recordings of my/their voice. I further grant Carers in Bedfordshire the right to use my/or my child’s imagery and/or recordings in promoting the organisation on the website, in publications, on social media, marketing materials, displays or in the media.
*
Yes
No
I agree to inform Carers in Bedfordshire if my child cannot attend an event at my earliest convenience.
*
Yes
Save
Submit
Should be Empty: