We would like you to let us know an emergency contact number Convenors and Group Leaders can use to contact relatives or a person who would be interested in your welfare in the event of an incident or emergency involving you while attending a u3a organised meeting or event.

Please complete the form below and click the send button when complete. The information will be available to Convenors and event organisers to access in the event of an emergency and will be stored securely on our Beacon system where only your Group Convenor and a limited number of committee members will have access.

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Please enter your Membership Number, if known.

Your name *

First

Last

know contact, known.

Email address. Required. *

Your mobile phone number (if you have one).

Emergency contact number. Please let us know who we can contact on your behalf in case of an emergency. Please tell us their name and relationship, together with their phone number, preferably a Mobile Number.

If you prefer not to tell us about an emergency contact, click the box below. Please still submit the form so that we can record your wishes.

• I prefer not to give emergency contact details.

Submit