Thank you for your interest in this event. To book a place, please complete all fields in the form below and press submit.

You may find it helpful to review the full programme as well as the session descriptions to inform your breakout group choices. 

We recognise that it can sometimes be hard to know at the time of booking where you will be up to in your treatment by the time the event comes round and that sometimes other things can come up which might mean you are no longer able to attend. It’s not a problem if you need to cancel but please do let us know as soon as possible so we can offer your place to someone else.

If you experience any difficulties with this form you can email us at youngerwomen@breastcancernow.org or call 0345 077 1893.

Please note your place is not confirmed until you have received an email from us letting you know you have been booked on to the event.

About you
Date of birth *
About your diagnosis
Date of most recent diagnosis
About the Event
Breakout groups
Click here for more information about these groups. 

Please indicate your choice of breakout group for each session. 

First breakout group. Please number these in order of preference with 1 being your first choice.

Second breakout group

Please number these in order of preference with 1 being your first choice

Participant information - please read this carefully before agreeing to the statements below

We expect everyone using and attending our services (staff, volunteers and participants) to show each other due consideration, respect and understanding and to follow the ground rules agreed at each event.

All our services are free. All we ask of you is to attend and fully commit to the whole programme.

If you are no longer able to attend pease let us know as soon as possible so that your place can be offered to someone else.

The number of participants in each breakout group is limited so that everyone gets enough time to share and contribute as fully as possible. We will do our best to give you your first choice, however sometimes it may not be possible to do this for every session. Please contact us in advance if you think you would like to change your group and we will try to accommodate your request, as this will not be possible on the day. 

Keeping in Touch
We’re always looking for media ‘case studies’. If you’d be interested in talking about your experience to the media with our support, please tick here

Keeping in touch with Breast Cancer Now

We'd like to tell you ways you can help further, including through donating, fundraising, campaigning and volunteering and send you updates on our research, the support we provide, breast health information, and our wider work to achieve our aims.  

If you already hear from us, we will continue to contact you in the same way. If you don't already hear from us, please tick the box if you are happy to be contacted by: 

How we use your information

From time to time, we may contact you by telephone and post about Breast Cancer Now, to keep you updated on our work and ways you can help. You can change the way you hear from us at any time by emailing us at feedback@breastcancernow.org or calling us on 0333 20 70 300.

To help us to work more efficiently, we may analyse your information to make sure you receive the most relevant communications, and to target our digital advertising. This may include using publicly available information. You can ask us to stop this at any time, by contacting us using the above contact details. You can read more about how we will use your information in our Privacy policy.

 

Equality and diversity monitoring

We would like to encourage you to complete this part of the form. Breast Cancer Now has a clear diversity strategy; we monitor the profile of our users and work hard to make ourselves accessible to those we find to be under represented.