Queen Elizabeth School, Wimborne, BH21 4DT
5.00 – 8.30pm
Tuesday 23 April 2019
(Under 16’s please come with your carer or an accompanying adult)

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* 1. Please tick the relevant box below

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* 2. First name 

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* 3. Surname 

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* 4. Age of young person attending

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* 5. Name of accompanying carer/adult attending for under 16 yrs

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* 6. Email address (this will only be used in case of cancellation)

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* 7. Contact telephone number (this will only be used in case of cancellation)

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* 8. Professionals, : Name of organisation or group that you will be representing. Please type 'self' if you are not part of an organisation

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* 9. Please tell us if you have any access or allergies/ dietary requirements


Thank you for booking a place.

Please note that once you click "DONE" below, your booking is complete.

We look forward to seeing you on 23rd April 5pm @Queen Elizabeth School.

Data will be used lawfully and in accordance with Data Protection legislation.

Click here for more information about how we handle your data.

If you change your mind about us holding your information at any time, or you would like to cancel your booking to come to the event please contact communications@dorsetccg.nhs.uk

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