Wellbeing Weekend Application

All rooms are ensuite and have either a shower over a bath or a shower cubicle. The Shower cubicles have a step into them approximately 6” high. The wheelchair accessible rooms are designed for the needs of wheelchair users, and have a wet room style shower. They are limited, so will be allocated to those least mobile only. This will be done on a first come, first served basis and we will operate a waiting list to reallocate the room in the event of a cancellation.

The Hayes imposes strict cancellation charges: with 14 days to 4 months notice – 75% of the total value of the cancelled booking and with less than 14 days notice – 100% of the total value of the cancellation is charged to Mutual Support.Unfortunately we have had to pay cancellation fees for non attendees in the past. This impacts the funds we have to put towards future events so please only complete the application form if you fully intend to join us.

Name of person living with MS(Required)

Are they:(Required)

Which of the Armed Forces do they belong to?(Required)

Partners Name(Required)

Are they:(Required)

Which of the Armed Forces do they belong to?(Required)

Address(Required)

Street Address City Post Code

Phone(Required)

Email(Required)

What wellbeing event are you looking to attend?(Required)

No. of adults attending(Required)

No. of children (under 16) attending(Required)

Please provide names and ages of children attending.

Put you up types can be supplied for small children sharing rooms, please let us know if these are required

We will arrive on(Required)

We will arrive at(Required)

Have you attended any residential weekends before?(Required)

In an emergency, are you able to offer assistance to others?(Required)

What style of room do you require?(Required)

Are you a wheelchair user?(Required)

How far can you comfortably walk?(Required)

Do you anticipate bringing your professional carer with you?(Required)

All meals comprise an extensive hot and cold served buffet with plenty of choice, do you have any specific dietary requirements that need catered for?

Sunday Lunch(Required)

Anything else we need to know?

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