I am happy for my child to take part in this assessment. I understand that, while bibic will take all reasonable care of my child, unless they are negligent, they cannot be held responsible for any loss, damage or injury suffered by my child.

I give consent for bibic to administer basic first aid, and/or authorise medical treatment (as advised by medical staff) should it be deemed in the interest of my child’s health and safety to do so.

Featuring family stories, photos, videos and quotes in our marketing and communications can help bibic raise more money or help other families understand how bibic can help their child.

I am happy for photographs and/or video of my child to be taken whilst taking part in the sessions and used to publicise the work of bibic and to our funders, and other fundraising purposes. To protect privacy we will not use names unless the child is part of our Sponsor a bibic child programme.

I consent to our data being gathered, stored and processed (in line with our privacy policy) so that bibic can provide support to my child. I understand that these details will be kept for up to 7 years. All data will be securely stored and not shared with any third parties.

bibic need to raise £1,485 towards the cost of every full assessment, therapeutic plan and support for families. We would like to keep in touch with you about fundraising and marketing. I consent to bibic contacting me about fundraising events, activities, and marketing.

Please tick if you would like to be added to our cancellation list. (You must pay half of the assessment amount beforehand; this payment can be made over the phone, via bank transfer or you can set up an early payment plan).