Registration Form for Action Duchenne Members, Non-Members, Families, Children, Living with Duchenne and Carers

 

PLEASE NOTE: If you are registering for the conference as either of the following, please click here to register for your tickets:

  • Pharmaceutical Company
  • Other Professional
  • Postgraduate Student
  • Voluntary Sector Organisation
  • Speaker

 

If you are an Action Duchenne Member, Non-Member, Family Member, Child or Carer please continue to register below. 

Main Group Contact

Contact Details (if not attending the event)

Primary Address

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Group Members

Please select the ticket type required below. This applies for the first person only, you will have the option to select the ticket types for other group members afterwards.

If you would like to utilise the 2-4-1 member discount please purchase two 2-4-1 member tickets first

Please select the days you would like to attend. To obtain the 2 for 1 discount on this ticket, please purchase 2 of these ticket types in a row and the total amount to pay will be adjusted accordingly.

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Please select the days you would like to attend

2 Day Tickets (Friday & Saturday)

 

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Please Note: This ticket is only available to those who have Duchenne. If you are a parent or carer, please book using the other tickets available.

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Friday Only Tickets 

 

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Please Note: This ticket is only available to those who have Duchenne. If you are a parent or carer, please book using the other tickets available.

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Saturday Only Tickets

 

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Please Note: This ticket is only available to those who have Duchenne. If you are a parent or carer, please book using the other tickets available.

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Contact Details

Primary Address

Please note, your full name and dietary requirement if provided will be shared with the Jurys Inn Hinckley Island for the purpose of delivering this event.

Action Duchenne would like to offer families a £50 grant towards their conference accommodation to help towards the cost of attending the event. This grant is available due to the generosity of our sponsors for the event. Action Duchenne will be in touch with you after the event to arrange the reimbursement. There is one grant available per family.

I agree to share my first and last name on the delegate list

If you would like to add dinner for Friday 11th November please select this below:

AMOUNT
30.00
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8.50
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If you would like to book the Creche please select the days required below (for children aged 0-9)

We have a limited number of creche spaces for children during the Conference. 

Action Duchenne will confirm the availability of the creche placement with the Parent/Guardian ahead of the Conference. 

If you would like to book the Hangout please select the days required below (for children aged 10-17)

Child Details

Please note, your full name and dietary requirement if provided will be shared with the Jurys Inn Hinckley Island for the purpose of delivering this event.

Please click the days below you would like to book the Creche (for children aged 0-9)

We have a limited number of creche spaces for children during the Conference. 

Action Duchenne will confirm the availability of the creche placement with the Parent/Guardian ahead of the Conference. 

 

Please select the days below you would like to book the Hangout (for children aged 10-17)

Please select dinner below if you would like to add a child dinner for Friday 11th November

AMOUNT
8.50
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AMOUNT
30.00
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Summary

Please note that if you are purchasing a 2 for 1 ticket type, ensure that you complete the registration form for 2 of these in a row and the total amount to pay will then be updated below. If you are having problems with your booking, please call 02476 369 747

Terms and Conditions

Payment

Thank you for Registering to attend the Action Duchenne International Conference. You will shortly receive a booking confirmation to your email. Should this not arrive please contact adconference@conferencecare.com or call +44 2476 369747  for assistance.

Don’t forget to book your accommodation if it is needed. The venue is offering hotel rooms at the special Action Duchenne rate. There are also alternative local hotel options. Please click here to view the accommodation options.

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