Breakaway expression of interest



Let us know you are interested in attending CLDF Breakaway by completing the form below.

A member of our young people’s team will then be in touch with you and your parents to discuss your application for the event further. Please note places are limited and a £30 deposit will be required.










Parent's Details



I confirm I have discussed this with my parent(s)/carer(s) and have their approval

Your Consultant's Details




I give my permission for you to contact my consultant to confirm I am physically and medically fit to take part in CLDF Breakaway

Tell Us How You Want To Hear From Us

Children’s Liver Disease Foundation would love to keep in touch with you about our vital work. By contacting you in the way you choose, we can be more cost effective in our communications and marketing activity.

What would you like to hear from us about and how?

Please note:
1. We don’t send much post so if you only choose one option email would be best.
2. We’ll update all contact preferences on our systems within 30 days of receiving your request.

By postBy emailBy phone (a call from a member of the CLDF team)By text/SMS
By postBy emailBy phone (a call from a member of the CLDF team)By text/SMS
Don't contact

Your details are safe with us

We'll always store your personal details securely. We'll use them to provide the service that you have requested and communicate with you in the way(s) you have agreed to. Your details may also be used for analysis purposes, to help us provide the best possible service. We won't sell your details to anyone else and we'll only share them with suppliers working on our behalf, or if required to do so by law. For full details please see our Privacy Policy. It's important that you read this policy to understand what information we hold, how we use it and what your rights are.