Register Interest

Please complete the form to register with Recharge Workshops & Retreats

We encourage everyone to register with their Trust Carer Coordinator.

We will not share your information with other parties. However general information, such as workshop choice & Trust Area etc will enable us to provide information to our funders.

Name

First Name

Last Name

Address

Postcode

Phone

Your Health Trust

I consent to the Recharge Privacy Policy

Date

Date of birth

YYYY

I am eligible for reduced fees due to one or more of the following -

unpaid carer

disability/illness/disease

mental/emotional health

bereavement

unwaged