Become A Base Member

The Base offers a wide range of activities for young people with additional needs and their families, so why not consider becoming a member.

The Base Membership Form

1
Child Membership Details
2
Family Contact Details
3
Other Details
4
Consents
5
Parent/Guardian Sign Off

Child 1 Membership Details

Child 2 Membership Details

Child 3 Membership Details

Child 4 Membership Details

Family Contact Details

Other Details

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