Online Application - Young IA weekend 2010

Please note that all bookings are subject to the following conditions:.

• Attendance is open to anyone between the ages of 18 and 40.
  
  
• Any cancelled bookings after 30th July 2010 will be subject to a cancellation fee, which may be up to the full amount paid.
  
  
• IA (The Ileostomy and Internal Pouch Support Group) cannot be held responsible for any loss, damage or injury incurred by delegates whilst attending the Young IA weekend.
  
  
• Any member of IA who may be unable to attend this weekend on the grounds of cost can apply for financial help to attend the weekend through the Young IA Bursary Fund. Anyone interested in applying to the Bursary Fund should contact IA National Office (info@iasupport.org)
  
  
• All bookings must be received by 23rd July 2010

Title	Mr. Mrs. Miss. Ms. *
First Name	*
Surname	*
Address	*
Address
Address
Address
Postcode	*
Country	*
Tel	*
Email	*
Age?	18-25 26-35 36-40 *
Are you a member of IA? If so which member organisation do you belong to?	*
Special Requirements? (e.g. diet)
How did you hear about the weekend?	*
Total:	Weekend (£50)
Can your details be retained for future Young IA events?	Yes No
Please complete the above form then click 'Proceed' to connect to the Secure Server (where you can enter you card details with complete confidence) Refunds Policy: All refunds are at the discretion of IA