Registration Form - Children In Hospital

Name *

Email *

Phone Number *

Advisor roles I am interested in:

Monthly Working Group

Healthcare transitions - parent/carer

Healthcare transitions - patient under 18

Healthcare transitions - patient over 18

Patient advisors under 18 will require parent/guardian consent to participate. Please provide parent/guardian name, email and phone number.

I would like to receive the following:

Children In Hospital Ireland Quarterly Newsletter

Information on new advisor opportunities

Information on upcoming workshops and events

Fundraising Registration