Name of Child *

Childs Date of Birth *

Name(s) of Parent(s) / Guardian (s) *

Address *

Post Code *

Phone Number *

Email Address *

Diagnosis *

Date of Diagnosis *

Name(s) of Brother(s) / Sister(s)
with Date of Birth



copars

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above in lower case and without
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Register now online for Copars Membership.

Membership is free

We send out newsletters to
all our members

Regular events for the
whole family

Events include Summer BBQs,
Theme Parks and Pantomimes