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First name *

Last name *

Email *

Mobile *

Your age *

Your gender *

Female
Male
Non-Binary

Who are you interested in *

Female
Male
Non-Binary

Do you have a preferred age range that you are seeking? (You can select more than one age bracket if applicable/ or indicate in the additional information box) *

What services are you interested in *

Our services can be offered in the following age selections. Which would suit you? *

18-30
28+
Over 50s

Is there any additional information that you would like to let us know

Please let us know how you heard about Unified Dating *

Please tick the box next to each type of email communication you consent to receive from Unified Dating (We will still send transactional and event update emails and event reminders by email/ SMS texts)

All Email Communications (Emails of future Unified Dating events, activities, experiences, weekend breaks and holidays)
Emails of Future Unified Dating Events
SMS texts of Upcoming Events
Emails of Future Activities
Emails of Future Experiences
Emails of Future Weekend Breaks
Emails of Future Holidays
Marketing Communications (Updates of new services, products, features or special offers that we introduce)

Please read and agree to our Terms & Conditions and Privacy Policy *

Please tick box to agree to our Terms and Conditions. Click here Please tick box to agree to our Privacy Policy. Click here