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Cancer Awareness & Education - Registration

This programme runs sessions and workshops to improve cancer understanding, reduce fear and stigma, and support families affected by cancer. Please complete one form per participant. All information is confidential and used only for programme delivery and safeguarding.

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Your details

Step 1 of 4

Full name *

Phone *

Email *

Date of birth *

Age *

Gender *

FemaleMalePrefer not to say

Ethnicity *

Address & Post Code *

Emergency contact name *

Emergency contact phone number *

Relationship to participant *

Do you have any medical conditions we should be aware of? *

YesNo

If Yes, please provide details

Only if you answered Yes above.

Do you have any accessibility or support needs? *

YesNo

If Yes, please describe the support required

Only if you answered Yes above.

Have you or someone close to you been affected by cancer? *

YesNoPrefer not to say

If Yes, would you like to share anything about this experience?

Optional.

Which topics are most important to you? *

Understanding cancerScreening and early detectionCultural or faith-related concernsHearing real storiesNavigating the NHSSupporting a loved oneSupporting children and familiesOther

Some sessions may include sensitive discussions. Do you consent to participate? *

YesNo

Would you like access to emotional support during or after sessions? *

YesNoMaybe

Do you give permission for photos/videos to be taken for project reporting? *

YesNo

Do you consent to Family Unit Trust storing your information for project purposes? *

YesNo

Signature (Full Name) *

How did you hear about this programme? *

Social mediaWord of MouthCommunity OrganisationGP / Health ServicePoster / FlyerOther

Your information is confidential and used only to deliver this programme. See our privacy policy.

Help us make sure no family faces cancer alone.

Your support funds awareness, food, youth wellbeing and family support.

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Family Unit Trust

An award-winning Manchester charity strengthening families, raising cancer awareness and tackling health inequalities since 2020.

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Unit 11, Varley Industrial Estate, Miles Platting, Manchester, M40 8EL

info@familyunittrust.org.uk

Mon - Fri 9am - 4pm · Saturday 9am - 2pm

King's Coronation Champions Award 2023Global Champions Award 2025CAHN Leadership Award 2025Charity of the YearOutstanding Social Behaviour Award 2023

© 2026 Family Unit Trust · Charity No. 1190524

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