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BRITISH THYROID FOUNDATION – CHILDREN’S CONFERENCE 2017

REGISTRATION FORM

Thank you for contacting BTF to find out more about our children’s conference. The meeting will take place on Saturday 13 May 2016 at the Abbey Centre in Westminster, Central London) between 10.30am and 4pm3.30pm. There is no cost for attending the conference but we do require a refundable deposit of £25 to secure your family’s place. Unfortunately places at the meeting are limited and we can only allocate a maximum of three places per family.

The aim of the meeting is to provide information about thyroid disorders and how they can affect children. We have lined up some excellent medical speakers who will talk about different thyroid disorders, common symptoms, diagnosis and medication. They will also discuss ongoing care and give some practical tips and suggestions about ways to manage thyroid disease as your child grows.

Importantly, the day will also be a chance for families to meet each other and to share and discuss common experiences.

Although the event is aimed at parents and carers, the Abbey Centre does provide a crèche and so there will be limited childcare spaces provided in an adjoining room. For those children who do attend there will appropriate opportunities for them to learn more about their thyroid and why it is important.

In order to secure a place for your family please send in the following information together with a deposit of £25* by 30April 2017. Cheques should be made payable to the British Thyroid Foundation and completed registrations should be received by 30 April 2017.

1. Contact details

Your Name:

Address:

Email address:Telephone number:

2. About your child

(a) Name:

(b)Date of birth:

(c)Male/Female(please delete the answer that does not apply)

(d)Thyroid disorder (please insert ‘X’ alongside all that apply in the following list):

Thyroid disorder / Yes
Hyperthyroidism (over-active thyroid)
Hypothyroidism (under-active thyroid)
Thyroid cancer
Thyroid eye disease
Other - please provide brief details:

(e)Would your child like to join in age appropriate activities or are they likely to stay with you? This will give us an indication of the numbers of children we need to make arrangements for.

My child would probably like to join in activities with other children

YesNo(please delete the answer that does not apply)

(f)Besides you and your child, please provide details of any other person who will accompany you:

(g)Please give details of any dietary requirements or special needs:

(h)Are you a member of the BTF?YesNo(please delete the answer that does not apply)

(i)To help us get a better idea of what families would like from the meeting, please prepare three questions you would like answered.

(i)……………………………………………………………………………………..…….…………..

(ii)……………………………………………………………………………………….………………

(iii)…………………………………………………………………………………………….…………..

(j)If you are interested in helping the BTF to support children with thyroid disorders (and their families and carers) in any way then please let us know. If you have any suggestions as to how you’d like to get involved please give details:

……………………………………………………………………………………………………………

Closer to the event we will send you details of the final arrangements and how to find the venue. If you have any queries in the meantime then please contact Julia Priestley by phone (tel: 01423 810093) or email.

Please return this form either:

By email to: or

By post to:Children’s Conference (BTF)

Suite 12, One Sceptre House

Hornbeam Square North

Harrogate

North Yorkshire

HG2 8PB

*Please note that BTF will not bank your deposit cheque before the conference and it will be returned to you when you turn up on the day. If, having paid the cheque, you are not able to attend then we will return the cheque to you so long as you give us a minimum of 7 days notice. If you are not able to attend the meeting and do not give us the required notice we reserve the right to keep the deposit as part payment of the conference costs which BTF will incur.