Understanding the Emotional and Behavioural Needs of a Child with Cancer Virtual Talk Registration
Reserve your place by sharing your details and preferences for the Zoom session.
Section 1 - Your Details
Full name
*
First Name
Last Name
Email address
*
example@example.com
Phone number (WhatsApp preferred)
Please enter a valid phone number.
Format: (000) 000-0000.
Country / City
Section 2 - About You
I am registering as a
*
Lion / Leo-Lion
Parent / caregiver of a child with cancer
Family member or friend
Healthcare professional (doctor, nurse, allied health)
Counsellor / social worker / psychologist
Volunteer / NGO representative
Teacher
Leo
Student
Other
Organisation / Institution
Section 3 - Question
Do you have a question for the speaker? (Please do not include your child's name or personal medical details.)
How did you hear about this talk?
Social media
WhatsApp
Hospital or organisation
Friend or colleague
Other
Section 4 - Consent
I agree to receive the Zoom link and reminders by email.
*
Yes
No
I understand that my information will only be used for this event.
*
Yes
No
I’d like to be informed about future talks.
Yes
No
Register
Should be Empty: