surrey

Registration for under 25 years old who live in Surrey

If you are between 16 and 24 years old you can register online, all you need to do is fill out your details and we will email you with a virtual c-card which will allow you to pick up free condoms at any participating outlet across Surrey. If you chose to you can receive your first supply of condoms in the post.

Under 16 years old? You can still register for c-card

Please note if you are under 16, you can register for a c-card by visiting your nearest outlet that provides the registration service. Find your nearest outlet.                    

All information is secure and confidential, no details will be passed to your parents / carers, your school, college or Doctors.

 

 

about you

Please complete all the required fields below. Any blue fields are optional.

Initial  & Surname
 
Date Of Birth
/ /
Gender
Ethnic Background
Sexual Orientation
Postcode

Please enter Postcode and click 'Lookup'.

Why we ask for your postcode? (show)

How did you hear about the Scheme?

Email Address
Confirm Email Address
Condom Demonstration
Please tick to confirm you have watched the Condom Demonstration.
Data Protection

Show Statement



Resident of Borough *
Mobile Number