ONE Event 2019 Special Needs Request Form
Complete this form if you have a Special Need and/or disability and require our support.

All forms must be submitted by 31st July 2019 for consideration.

General Details
Please complete this section with the details of the person with Special Needs and/or disabilities
Full Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Age at Event (August 2019) *
Your answer
Venue Attending *
Please tell us which venue you plan on attending for main meetings
Church Attended *
Just in case we need to verify any details with you Church Leader
Your answer
Church Leader *
Your answer
Booking Contact
Please complete this section with details of the Booking Contact
Full Name
If different from above
Your answer
Home Address *
Your answer
Postcode *
Your answer
Home Phone Number *
Your answer
Mobile Number *
Your answer
Email Address *
Your answer
Are you camping, event pass, residential or day visitor *
Carer Details
Does the person with special needs and/or disabilities have a carer? Is so please tell us below, please note we can only supply free carer passes to carers who are only attending the event to care.
Carers Name
Your answer
Carers Mobile Number
Your answer
Please confirm if your carer is only attending the event due to your Special Needs?
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