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Please complete all sections fully to enable us to ensure that you can access sessions safely alongside the person you support. All information will be held in confidence.

Carer/PA/Support Staff Registration Form

Personal Details

DD slash MM slash YYYY

Emergency Contact Details

Health Conditions

Do you have any medical conditions?(Required)
(We ask because we have a duty of care to carers/PAs/support staff who attend/participate in sessions alongside the person they support)

Other Health Information

Do you have any allergies?(Required)

Information required to access specific sessions such as cycling, Flexi-Bounce Therapy, or any other session using equipment with height or weight restrictions

Kg or stone

DD slash MM slash YYYY