Book Your Place at Wild Camp 2022

Adult Details

Details of the adult who will be joining us on Wild Camp

Title—Please choose an option—MrMrsMsMissSirMadamDrProfessor
First name
Surname
Ethnicity—Please choose an option—Asian/Asian British - BangladeshiAsian/Asian British - ChineseAsian/Asian British - IndianAsian/Asian British - PakistaniAsian/Asian British - Any other Asian backgroundBlack/Black British - AfricanBlack/Black British - Any other Black backgroundBlack/Black British - CaribbeanMixed/Mixed British - White and AsianMixed/Mixed British - White and Black AfricanMixed/Mixed British - White and Black CaribbeanMixed/Mixed British - Any other multiple ethnic backgroundWhite - English/Welsh/Scottish/Northern Irish/BritishWhite - Gypsy or Irish TravellerWhite - Irish (Southern)White - Any other White backgroundOther - ArabOther - ChineseOther - Any other ethnic group

Please tick to give us your explicit consent to process your/your child(ren)’s ethnicity details

Home address
County
Postcode
Country
Email address
Phone number

Child's details

Title—Please choose an option—MrMasterMissMs
First name
Surname
Ethnicity—Please choose an option—Asian/Asian British - BangladeshiAsian/Asian British - ChineseAsian/Asian British - IndianAsian/Asian British - PakistaniAsian/Asian British - Any other Asian backgroundBlack/Black British - AfricanBlack/Black British - Any other Black backgroundBlack/Black British - CaribbeanMixed/Mixed British - White and AsianMixed/Mixed British - White and Black AfricanMixed/Mixed British - White and Black CaribbeanMixed/Mixed British - Any other multiple ethnic backgroundWhite - English/Welsh/Scottish/Northern Irish/BritishWhite - Gypsy or Irish TravellerWhite - Irish (Southern)White - Any other White backgroundOther - ArabOther - ChineseOther - Any other ethnic group
Date of birth
Liver condition
TransplantYesNo
Please tick to give us your explicit consent to process your/your child(ren)’s health information

Comments/additional requirements

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 about from us 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 21 days of receiving your request.

CLDF support services, family/young people events and general information and updates, including our Liver Life magazineBy postBy emailBy phone (a call from a member of the CLDF team)By text/SMS
CLDF Fundraising events and activitiesBy postBy emailBy phone (a call from a member of the CLDF team)By text/SMS
Alternatively, if you no longer wish to hear from CLDF at all please tick this boxDon'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.

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