Register With Project CASK

Contact Information

First name

Last name

Phone - if error msg, enter 111-111-1111

Spouse or partner's name

Spouse/Partner's First name

Spouse/Partner's Last name

Sign me up for the Project CASK Newsletter

Yes please

Mailing Address

Address Line 1

Address Line 2

City

Country

State

Provinces

State/Province

Postal Code

*Please enter N/A if State/Province is not applicable

Are you the parent/legal guardian of a CASK individual?

YesNo

CASK Individual's Information

CASK individual's name

CASK Individual's First Name

CASK Individual's Last Name

Birthdate

Gender

Approximate diagnosis date

CASK Angel

This person has gained their wings/has passed on

Genetics Informaiton

A genetics report is one of the first steps toward effective research for our families. At this time Project CASK is not collecting reports, however they are invaluable to have on hand for our HIPPA compliant partners, in advancing research.

I have a copy of this person's genetics reportI need help accessing this person's genetics report

Awareness Activities

Honor your CASK loved one by adding their name and country to this year’s Rare Disease Day t-shirt! Rare Disease Day is the last day of every February. 2025 deadline to add names is Sunday January 19.

Yes, please add my CASK loved one's first name and country

Connect with locals

Would you like to be connected to other CASK families in your surrounding area?

Yes please!No thank you

Media

Yes, I'd like to send in photos/videos of our family to help Project CASK advocate for our children!No thank you

Volunteer with PC

Interested in volunteering with Project CASK?

Yes!Kinda... I have a lot on my plate but might like to do something small!

Fundraising

Yes, I would love to learn more about planning an event!Yes, I would love to do something with minimal effort, like an online share!

Research

Yes, I would like to learn more about the CASK epilepsy study currently enrollingYes, I would like to learn more about how my family can contribute to important research tools to push the development of treatments forward

Upon successful submission, you will be redirected to Project CASK's partner, Citizen Health. Please consider taking 5 minutes to register with Citizen Health to advance CASK research. More info