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Registration
Form "School Holiday Activities Registration"
School Holiday Activities Registration
Note:
Everything marked with a
*
is a required field.
*
Participant Full Name
*
Parents/Carers Full Name
*
Address
*
Borough
*
Post Code
*
Date Of Birth
dd/mm/yyyy
*
Gender
Male
Female
Prefer Not to say
*
Email
*
Phone No#
*
Country of Origin
*
School Name / Address
*
School Year
*
On which Activity time will you attend?
Summer
Autumn Term (Christmass Holiday)
Spring Term (Easter Holiday)
*
How do you live by the end of the class?
Parents Coming
With Relativies
Foster Care
By Myself
Other, Please Specify below
Other
How do you live by the end of the class?
*
Do you have disability or any medial Condition
No
Yes
If Yes, Please describe below
If you have disabilities, please Describe
*
Full Name for next of keen
*
Next of keen Telephone number
*
Participant Consent Declaration
Agree
Disagree
I confirm that the information provided is accurate. I have read and agree to the LDC policies, including the Code of Conduct, safeguarding, equal opportunities, complaint procedures, health and safety, child protection, and data protection (GDPR). I understand that LDC is committed to child safety and will not allow photos or videos of children without parent/carer consent. By participating in LDC activities at 71 Kingsgate Road, I give permission for my child’s images to be taken for record-keeping and evaluation purposes, which may be shared with trustees and funders. My information will not be shared with third parties except with legally responsible bodies or funders for statistical purposes, in accordance with data protection laws
*
Signature of Participant/ Parent
If you can't put your signature, type your full name and phone number
*
Date
dd/mm/yyyy
