Please sign up here to register to use our services and attend our events.  You are eligible to receive our services if you were diagnosed with cancer or have cancer between the ages of 20-45 years old.  

Name *
Date of Birth *
This helps us send information that is specific to you
Gender I identify with:
Ministry of Health Ethnicity Groups
Other, please describe
Address *
Preferred Phone for Contact *
Photo Release
Oxygen Skincare
Oxygen Skincare partner with us to make life after a cancer diagnosis a little bit easier. Each new member will receive a free gift of skincare from their range. By checking this box, you are confirming that you are okay with us giving Oxygen Skincare your postal address so that they can send you this gift. They will NOT use this information for anything except sending you a gift. You will not be added to any marketing lists etc.

Thank you for your interest in our services!

We collect personal information from you in order to safely provide support and services for you and the rest of our community.  This information is confidential and only our staff have access to it.  We never pass on your information to any third party, unless required by law.

Providing some information is optional. If you choose not to enter a completed membership form however, we'll be unable to accept you for our retreat programme.

You have the right to ask for a copy of any personal information we hold about you, and to ask for it to be corrected if you think it is wrong. If you'd like to ask for a copy of your information, or to have it corrected, please contact us at, or 0211199127.