Contact – Connect4Summer

Name

Mobile Phone

Email

Create your password*

Strength indicator

Town/Postcode*

Parents Dietary Requirements

NB. your Child's requirements will be detailed on a separate form.

Dietary (other)

Once you have submitted your Parent/Guardian/Carer registration, you will receive a confirmation email.

Are you the only person who will be accompanying the child/children?*

Yes
Add an accompanying adult

Name of accompanying adult

Mobile Phone # of accompanying adult

Contact email for accompanying adult

Dietary Requirements of accompanying adult

Dietary (other) for accompanying adult

Child's details 1

Child's Name

Child's Date of Birth

Town/Postcode*

Same as parent

Which School does this child attend?

This child attends...
	Edit Delete
There are no Schools selection.

Maximum number of schools selection reached.

Child's Dietary Requirements

Dietary (other)

Is the child entitled to Free School Meals?

Yes
No

Medical or SEN requirements

Please click the 'Add' tick-box to expand this form for adding another child's details.

+

Add another child

Child's details 2

Child's Name

Child's Date of Birth

Town/Postcode*

Same as parent

Which School does this child attend?

This child attends...
	Edit Delete
There are no Schools selection.

Maximum number of schools selection reached.

Child's Dietary Requirements

Dietary (other)

Is the child entitled to Free School Meals?

Yes
No

Medical or SEN requirements

Please click the 'Add' tick-box to expand this form for adding another child's details.

+

Add another child

Child's details 3

Child's Name

Child's Date of Birth

Town/Postcode*

Same as parent

Which School does this child attend?

This child attends...
	Edit Delete
There are no Schools selection.

Maximum number of schools selection reached.

Child's Dietary Requirements

Dietary (other)

Is the child entitled to Free School Meals?

Yes
No

Medical or SEN requirements

Please click the 'Add' tick-box to expand this form for adding another child's details.

+

Add another child

Child details 4

Child's Name

Child's Date of Birth

Town/Postcode*

Same as parent

Which School does this child attend?

This child attends...
	Edit Delete
There are no Schools selection.

Maximum number of schools selection reached.

Child's Dietary Requirements

Dietary (other)

Is the child entitled to Free School Meals?

Yes
No

Medical or SEN requirements

Consent

Covid-19, and GDPR*

I declare that I and all attendees joining me on Connect4Summer Family Fun Days will be healthy and will have not shown any symptoms of COVID-19 in the prior 14 days:
I also agree for my data to be collected and stored in compliance with GDPR standards.

I agree to the Terms listed above

Photography Policy

I agree

- for my family images to appear in the media/social-media and recorded in connection with Connect4Summer

Name

This field is for validation purposes and should be left unchanged.