Competition Contact Form

Your name*

Name of child/young person*

Age of Child/young person*

How you would like us to refer to your child in our announcement/marketing (e.g. first name or pseudonym)*:

Location (Town/first part of postcode)*:

Your email*

Telephone*

How did you hear about us? Please specify.*

What, if any, diagnosis does your child have?*

Tell us a little about the challenges your child faces?*

Tell us why you/your family deserve to win a Budii? What difference will it make to your life? What will it enable your child to do?*

I would like to join your email list to receive updates and news according to the following privacy policy.*

I certify that I am over 18 years of age and I agree to the following Terms and conditions and privacy policy*

If selected as a winner I agree to share information and/or photo’s showing the benefits of Budii for future marketing purposes by OM Interactive.*

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