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To apply, please complete this form

Please ensure that you only sign up to Little Soundabout/Soundabout Life if you reach the following criteria:

  • To be part of Little Soundabout you will have a child aged 0-5 with profound and multiple learning difficulties
  • To be part of Soundabout Life you will have a son/daughter aged 19-25 with profound and multiple learning difficulties

If you are unsure of whether you reach the criteria or not, please contact the project team to discuss further: info@soundabout.org.uk or 01235 797474 (Soundabout office phone number).

Consent: By giving us your personal details you are granting us permission to retain your information on our secure database for up to three years. You can unsubscribe at any time on request by contacting us.

If you have any questions, would like any support with completing the form, or would like to request a paper copy of the form, please do not hesitate to contact us: info@soundabout.org.uk or 01235 797474 (Soundabout office phone number).



Child/Young Persons Full Name:
Child/Young Persons Date of Birth:
Ethnicity:
Others at home (siblings, pets etc):





County:


Wheelchair User:
Visual Impairment:
Hearing Impairment:
Diagnosis Unsure/Currently Investigating:

Other needs:
Other relevant information eg. Diagnosis, Tube-fed etc:
How did you hear about us?:
Parent/Carer Agreement-Sign Here(type name):
Date Agreement Signed:
Parent/Carer Consent-Sign Here(type name):
Date Consent Signed:

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Soundabout will use the information you provide on this form to be in touch with you and to provide updates and marketing.

You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from us, or by contacting us at info@soundabout.org.uk. We will treat your information with respect. For more information about our privacy practices please visit our website. By clicking submit, you agree that we may process your information in accordance with these terms.

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