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Membership registration form

This page is for NEW members only. If you have ever been a member of the EACD please go to Renew Membership page to update your membership, otherwise this will create a duplicate account in your name. If you have lost your username please email admin@eacd.org and we will send it on to you. (after a security check). Thank you.

To complete the EACD Membership registration process you must complete a six part process which is outlined below.

1) Add details
2) Confirm details
4) Choose credit card type (WorldPay secure servers)
5) Credit Card Details (WorldPay secure servers)
6) Payment Confirmation (WorldPay secure servers)

Add details

* = required field

Title: Forename *: Surname *:
Address *: Town *: Post/Zip code *:

Country *:
Telephone *: Mobile: Other phone numbers:
Fax: Email *: Other Email:

* Confirm Email:

Areas of interest:
Profession *: Profession if other:
Gift Aid (UK Members Only):

As a registered charity, the EACD is able to treat the subscription as a donation, and to reclaim the national tax under Gift Aid donation. We would be extremely grateful if you would complete the Gift Aid Declaration below by ticking the relevant box, which enables us to do this. This does not commit you to any future payments, nor will you need to pay any additional tax.

Gift Aid Declaration:

I declare that I have made a donation to the EACD (Charity no 1015225) equal to the Annual membership fee, and I wish it to be treated as a Gift Aid donation. I confirm that I pay an Income Tax or Capital Gains Tax at least equal to the tax the EACD will reclaim on my donations in the coming tax year. I wish this arrangement to continue for as long as I remain a member of the EACD and also wish for any previous years subscriptions to be treated on the same way.

Data Usage | EACD & Third Parties:

I consent to receive communications from the EACD (including EACD Annual Meeting Conference Organisers) on news and events, by using the contact details that I provided (email).

EACD/AGM member Consent Declaration:

Third Parties
I consent that the EACD can pass on my details to carefully selected third parties (e.g. American Academy of Cerebral Palsy). Please note that details would never be passed on to any commercial companies. Tick the box below if you wish to consent.

Third Party Consent Declaration: