REGISTRATION FORM

REGISTER

Parents registering their child (under 18) are requested to fill in both the Adult & Child information. Information provided below will not be released and is not available to other members.

Membership Profile

** (we are trying to find out if there is a connection between certain ailments and blood types)

Select Your Ailment (Choose one only):*

NOTE: If you have more than one ailment you need to fill-in a different membership profile form per ailment. You must use the same User ID and Password for all. Parents registering their child (under 18) are requested to fill in both adult and child sections. These forms are strictly kept with the most privacy and will not be released under any condition, except by Court Order.

**For our purpose, a “Past” ailment is one that, after treatment, has not returned for over two years, or has been stabilized for over two years, or that you have been able to manage it for over two years, in which case you can click on it as your choice.

You can cancel your registration at any time by deleting your account.