Family Registration form

Registration

If you are booking for a group: after entering all attendee names below, the registration form will then ask you to select the registration type and details for each person in the group, one by one.

Please make sure the first member of a group is an adult / the main group lead for the booking.

Tick this box if you are not attending (booker only)

Lead booker - adult

Contact Details

First Name

Last Name

Email Address

Mobile

Primary/Billing Address

Line 1

City/Town

Country

Postcode

Group Members

Group Size

Action Duchenne are pleased to offer FREE Community Summit tickets to those living with Duchenne, their carers and family, children, siblings and young people, and Friends of Action Duchenne. These can be booked below.

With thanks to our sponsors, we are also able to offer a grant of up to £150 per family, for travel and accommodation for the Community Summit. Please tick the appropriate box, and we will be in touch regarding after the Community Summit.

If you are booking for multiple people, please complete the questions for yourself first then click 'register' on the summary page against each name to answer the questions for everyone in your party.

Please select your ticket type and what day(s) you would like to join us

Adult Person tickets

Adult - 1 Day Community Summit Pass: 13th November FULL

AMOUNT

0.00

TOTAL

Adult - 1 Day Community Summit Pass: 14th November FULL

AMOUNT

0.00

TOTAL

Adult - 2 Day Community Summit Pass: 13th & 14th November FULL

AMOUNT

0.00

TOTAL

Child / Young Person tickets

Child / Young person - 1 Day Community Summit Pass: 13th November FULL

AMOUNT

0.00

TOTAL

Child / Young person - 1 Day Community Summit Pass: 14th November FULL

AMOUNT

0.00

TOTAL

Child / Young person - 2 Day Community Summit Pass: 13th & 14th November FULL

AMOUNT

0.00

TOTAL

Would you like to join us as we celebrate 25 Years of Action Duchenne on Friday 13th November?

Each year we hold a dinner, and this year it will be a particularly special event to mark 25 years of the charity set up by Janet Hoskins and Nick Catlin. The evening will be 2001 themed, with a dancefloor and activities for all.

Number Of

Adult Dinner Ticket FULL

AMOUNT

40.00

TOTAL

Number Of

Child Dinner Ticket (ages 0-5) FULL

Number Of

Child Dinner Ticket (ages 5 - 10) FULL

AMOUNT

18.00

TOTAL

Number Of

Young Person Dinner Ticket (11-17) FULL

AMOUNT

30.00

TOTAL

Number Of

No dinner required FULL

A pre-order is required for the children's menu. There is a set starter for all: Mini Cherry Tomato & Mozzarella Mini Pizza - please select a main course and dessert below:

Please pre-order the children's main course options:

Please pre-order the children's dessert options below:

Other dietary requirements/allergies (see the next page of the form) will be catered for.

Lead Booker's Information

Contact Details

First Name

Last Name

Email Address

Mobile

Primary/Billing Address

Line 1

Line 2

City/Town

Postcode

Country

Additional Information

Dietary Requirements

Other

Accessibility Requirements (*)

None

Bed Raisers

Changing Facilities

Hoist

Shower Chair

Other

If other, please share more details if you wish

Is this your first time attending an Action Duchenne Community Summit/Conference?

Are you / the individual you are registering for living with Duchenne?

Are you / they ambulant / not ambulant?

Do you need any equipment to make their room accessible?

We are looking at having either exclusive use of the pool or a specific session in the pool (which has a hoist, and is set to 28-30 degrees Celsius and monitored) – would this be something you would be interested in?

We are also looking to do some seated sport activities, accessible for all, likely on Friday morning. Would this be something you would be interested in?

I would like to be contacted regarding a £175 grant towards travel and accommodation after the Community Summit

Tick here

To view the Action Duchenne Privacy Policy please click here

To view Conference Care's Privacy policy please click here

By making a Group Booking, the Lead Booker agrees and acknowledges that they have the consent of each group member to disclose their personal data (mandatory field*).

Data Processing Consent

* I give consent

Data Processing Consent option required

Adult's information

Contact Details

First Name

Last Name

Email Address

Verify Email Address

Mobile

Dietary Requirements

Other

Accessibility Requirements

None

Bed Raisers

Changing Facilities

Hoist

Other

If other, please share more details if you wish

Are you / the individual you are registering for living with Duchenne?

Are you/they ambulant?

Do you need any equipment to make their room accessible?

Child / Young Person's Information

First Name

Last Name

Additional information

Dietary Requirements

Other

Please note, if provided, the full name and dietary requirement will be shared with the venue for the purpose of delivering this event.

Any accessibility requirements?

Are you / the individual you are registering for living with Duchenne?

Are they ambulant?

Do you need any equipment to make their room accessible?

Age of the child at the time of the event

Would you like to book a place in the Creche: 0-3 years?

Number Of

Yes, please FULL

Would you like to book a place in Mighty Minds: 4-10 years?

Number Of

Yes, please FULL

Would you like to book a place in Trailblazers: 11-15 years?

Number Of

Yes, please FULL

Would you like to book a place in "Yes I Can": 16-17 years?

Number Of

Yes, please FULL

Paying it forward

We hope you see the value of this annual event. We want this event to be a firestarter, to be the beginning of conversations and to provide you with the connection which is so valuable in the Duchenne Community. To ensure we can do this together, funds are needed throughout the year not only for this event but for all of our on-going support and activities. We are a small charity and rely on our community to ensure we can not only continue our support but also to increase the support we can offer.

If you are able to do any of the following, we would really appreciate it:

1 - I will help Action Duchenne increase its impact by spreading the word to a friend

2 - I will make a donation today

3 - I would like to become a 'Friend of Action Duchenne' and sign up to make a monthly donation

4 – I’m not able to do this now.

Number Of

Donate £5 FULL

AMOUNT

5.00

TOTAL

Number Of

Donate £10 FULL

AMOUNT

10.00

TOTAL

Number Of

Donate £20 FULL

AMOUNT

20.00

TOTAL

Number Of

Donate £50 FULL

AMOUNT

50.00

TOTAL

Number Of

Donate £100 FULL

AMOUNT

100.00

TOTAL

Thank you for ensuring that our families do not have to face the future alone and that the next time one of our community need guidance, connection and a listening ear we can be there for them. Every family. Every time.

Summary

Terms and Conditions

I Agree

Payment

Thank you for registering to attend the Action Duchenne Community Summit 2026.

We will be in touch shortly with further information.

If you do not receive this please contact the support team on adconference@conferencecare.com

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