WDSSG Membership Form

Your Name (required)

Your Address (required)

Your Email address (required)

Your Contact telephone numbers
Telephone:
Mobile :

Please tick as appropriate.




, please state below

I/we DO NOT wish to be contacted by other families.
I/we DO NOT wish my details to be passed on to medical professionals.

Please note that the data protection act forbids the free distribution of members’ details without their express permission.