GRSNNZ Membership and Mailing Lists Subscription

GRSNNZ MEMBERSHIP & CONFIDENTIALITY AGREEMENT FORM

NB:
The question about consent for Private Facebook Groups relate to the groups used to organise your local and other support group(s) meetings and contacts.
*At the end of the form are options for you to subscribe to various mailing lists.
* indicates required
If joining for child
include area code
optional
Local and Other Support Networks
e.g. https://www.facebook.com/first.name
(You will be given the option to add additional family members when this form has been submitted)
choose primary diagnosis
...that we might be able to help you with - Details?
If any...
formula/breastfed/formula type/special diets

Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust (GRSNNZ) will use the information provided on this form to send newsletters and information as selected in your Mailing List choices. Other details are used for statistical and funding purposes. No identifiable information is released to third parties.

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