Become a member!

Membership is free. By becoming a member you will:

You can register using the online form on this page or mail in your registration.

Mail-In Member Registration

If you’d like to mail in or scan an application, please email us to request a word version.

Email: info@bccerbralpalsy.com

Online Member Registration

Membership Registration

Personal Info

If you are filling this in for an individual with cerebral palsy (CP), please enter their information.


For Parent / Caregiver / Guardian / Representative 

If you are filling this in for an individual with CP, please complete this section with your information.


Additional Info