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'Resilience in 2022' ASNA Carers weekend 2022: Registration Form
Please use this form to register for the ASNA event you would like to attend. We will send you the link for all the workshops once we receive this form.
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Email
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Your email
First name
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Your answer
Surname name
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Your answer
Postal Address
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Your answer
Telephone number
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Your answer
Please tell us about your caring responsibilities
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Your answer
Please confirm accommodation arrangements - There will be log cabins with 2 bedrooms (£250), 3 bedrooms (£350) and 4 bedrooms (£400).
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2 bed rooms
3 bedrooms
4 bedrooms
Other:
Please give the names of all those who will be in the log cabin
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Your answer
A 50% non refundable deposit will need to be made to secure the accommodation. Please indicate when you have made the deposit. Use your name as a reference when making the deposit. Bank details to make the deposit: Account Name: ASNABank: Lloyds Bank Account Number: 03151450, Sort Code: 30 91 53
Your answer
Thank you for sharing your details with ASNA. We do not take this lightly. Please indicate below whether you consent to ASNA keeping your details for ASNA purposes only. Your details will be stored with password protected security. Please let us know if you would like your details to be removed at any time. Your information will be stored for 3 years.
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Yes I consent to my information being stored as indicated above
No I do not consent to my details being stored
Other:
Please indicate below your consent to your image being stored or used for ASNA purposes (such as report writing, funding applications, promotion and marketing on ASNA social media platforms and website).
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Yes I give my consent for my image to be used as above
No I do not give my consent to my image being used for any purposes
I consent to a still image being used for hard copy material
I consent to video images being used as above
I consent to my photo images being used for ASNA hard copy material only
Other:
Would you like ASNA to send you further updates, or details of other ASNA or related events?
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Yes
No
Maybe later
Other:
A copy of your responses will be emailed to the address you provided.
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