Join us To become a full member of the Association, please fill in your details below or alternatively send your details via email or write to us at the address at the bottom of this page. Please correct highlighted items Your Details First Name Surname Address Postcode Country United Kingdom Other... Phone Number Mobile Number Email Address Confirm Email Address Your Child's Details Do you have a heartchild Yes No Child's First Name Child's Surname Date of Birth Heart Condition Other Information Contact Preferences Newsletters Yes No If you express a willingness to be contacted as part of the self-help group we will try to put you in contact with other families with similar problems and concerns as your own. Self-help group Yes No Confirm Entry Above you should see an image containing six letters (A - Z). Please enter these six letters in the box below (why?). Verification Only click once, submitting your membership request may take a short time. If you have any problems with the above form, please submit your membership request by email instead.