Online Registration Name(required) Email(required) Phone Number(required) Address(required) Date of Birth (ddmmyyyy) (YYYY-MM-DD)(required) Gender Select an option Male Female Transgender Blood Group (YYYY-MM-DD)(required) What is the preferred Language of communication? Select an option English Hindi Kannada Telugu Tamil Malayalam Bengali Sign language Others Is the Child walking without help? Select an option Yes No Does the child use a wheelchair for mobility? Select an option Yes No If ambulant how does the child find to climb up a flight of stairs? Select an option Easy Difficult Impossible Is the child going to regular school/college/University? Select an option Yes No Is the child on heart medication? Select an option Yes No Do you have reliable access to the internet? Select an option Yes No How did you hear about us? Select an option Search Engine Social Media TV Radio Friend or Family Medical Conditions SendSubmitting form Δ Share this: Share on Facebook (Opens in new window) Facebook Share on X (Opens in new window) X
Dystrophy Annihilation Research Trust 