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Please complete the following form to become a registered user of the West Cumbria Carers website.

Please Note

The information you provide on this registration form will be held in line with West Cumbria Carers Privacy Policy. The information will be held for the sole purpose of completing the Caring with Confidence Training Course and will not be used to contact you for any other reason.

First Name *
Last Name *
Telephone Number *
Date of Birth *
Address *
Area *
Are you a Carer? *
Email *
Password *
Password Confirm *
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