Free activities for Carers

Name

Address

Telephone

Email

DOB

How long have you been in a caring role and who do you care for? Please give details of their illness.

How would you prefer to be contacted?

Are you caring for more than one person, if so how many?

How many hours a week do you care for?

How did you find out about the project?

Why would you like to attend the project?

Please tick the activities you would like to attend
Location
LiskeardPenzancePendeenSocial meet ups across Cornwall

Activity
Swimming – fortnightlyPhotography – fortnightlyTai Chi – weeklySocial meet ups across Cornwall – monthly

How often can you attend?

We can contribute towards your travel costs; will you require this?

To ensure that you have every opportunity to participate in all areas of the project it will help us to know if you have any learning or physical needs. This information will be kept strictly confidential.

Do you receive benefits, or would you consider yourself economically disadvantage? Please explain.

Would you be interested in representing unpaid carers on this project as a Carers Champion? It is an informal role. This could involve making links with existing groups and networks that may want to be involved. Helping others in the project identify issues within the project and leading and facilitating individuals to devise ideas for the project. You would link in with the steering group to move these ideas forward.

Would you like to be part of a steering group for this project? This involves meeting with others on the project who plan activities. You may wish to volunteer to coordinate sessions and be given the opportunities to take the lead on different tasks or sessions. The group will also play a curial role in representing carers ideas in the direction the project takes, working closely with the carers Champions.

I consent to Promas CIC collecting and storing my personal data for the purpose of communicating and providing me with a service. I understand Promas CIC will not share my information with third parties and I can ask for my details to be deleted at any time by contacting Promas CIC.