Member application form for those who are attending the LHM Open Day & Annual General Meeting 23rd March 2024

For our members who wish to come and make it to our annual open day and AGM on the 23rd March, please complete the application form below:

Open Day 2024 - Member application form who are attending the LHM Open Day & Annual General Meeting 23rd March 2024

Please provide details of all parent members attending(Required)

Please separate names with commas.

Please provide the name of the heart child(Required)

First and last.

Please provide the age of the heart child(Required)

In months or years.

Please provide the condition of the heart child(Required)

Heart condition only.

Please provide the name(s) of any other Adults or child/children attending along with their age(Required)

Please separate names with commas.

Please provide your address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code

Email(Required)

Email Permissions(Required)

Yes I agree to LHM emailing me for future events and updates about the work of LHM, including support, information, fundraising and awareness campaigns.

No I don't agree

Little Hearts Matter may want to email you for its future events, please indicate your acceptance or not of their use by LHM in the future.

Phone contact number(Required)

Photo Permissions(Required)

Yes I agree to the LHM photo permission statement

No I don't agree

Little Hearts Matter may want to live broadcast or screen capture this event for publishing online, please indicate above your acceptance or not of their use by LHM in the future.

Would you like to stay for the evening meal

YES

Please provide any special dietary requirements(Required)

Please provide any special access requirement i.e. wheelchair access(Required)

Voting for election/re-election of trustees will take place at the AGM, if you are attending the event then please vote on the day, if you are not attending then please go to the voting form.

The Little Hearts Matter team know that circumstances for members can change before an event. We are always happy to cancel a place booked if someone is ill, as long as we are told before the event starts. Sadly, following the huge expense incurred by the charity last year for the Summer Event places booked but not attended, we are introducing a fee to cover some of our costs for non-attendees who do not inform us that they are unable to attend. The costs are £25.00 per adult and £20.00 per child.

There is a bursary available to families who would not be able to join us at the event without some support, please contact Little Hearts Matter via email (Tracy@lhm.org.uk) to request a bursary form.

Accommodation is available at Yarnfield Park Training Centre. Please call Yarnfield direct on (01785) 762605 and quote "Little Hearts Matter". Accommodation is also available at hotels near Stone, these are The Holiday Inn and Travelodge Hotels which are at junction 14 and 15 of the M6 and not far from Yarnfield. Links to these hotels can be found below.

Holiday Inn https://www.guestreservations.com/holiday-inn-stoke-on-trent-m6-jct-15-newcastle-under-lyme/booking?msclkid=048a30d63cc2136e9a84554e3034269d Premier Inn https://www.premierinn.com/gb/en/hotels/england/staffordshire/stafford/stafford-m6-southbound.html

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