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Manga Club Xpress Registration Form
Free autism friendly club for young people aged 10-16 years old .
4.30pm-6.00pm every Wednesday during school terms
Activities include: Drawing [including Manga characters] , watching Anime, playing Dungeons and Dragons, games, badminton, sports and crafts.  We are happy to develop activities suggested by the young people. Parents and Carers are welcome to drop off and pick up or to stay and meet other parents.
Light Refreshments provided.
At Westbourne Park Family Centre, Westbourne Park Baptist Church, Porchester Road, London, W2 5DX.
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Email *
First name of Young Person *
Last Name *
Address *
Post Code *
Date of Birth *
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School *
Age *
Parent/carer name *
Telephone Number *
Email *
Pick up *
Name and contact details of parent/carer and one other person we can contact in case of emergency. The named persons can also collect the child *
Does your child have any medical needs, allergies or additional needs? If yes please specify. *
Ethnicity *
*
Yes
No
Does your child receive free school meals?
Does your child speak English as an additional language (EAL registered)?
Does your childen have Special Educational needs (SEN registered)?
Does your child have an education health care plan? (EHCP)
Does your child have a disability
I will allow my child/children to participate in any photographs which may be circulated in promotional advertising, local newspapers or childcare magazines.
If you need to add any more information to help us understand your child's needs and give extra support please advise here
Once you have read our terms and condition at the bottom of the page please type your name below to confirm. *
Would you like to stay at the centre and chat with other parent/carers, while your child is attending the club?
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Would you like to stay at the centre and chat with our 1:1 professional support team?
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The child/youth care policy is an agreement between the parent/carer and the staff of WPFC. If any of the following areas were to be breached, then it may result in the exclusion of the child. Registration is from 4.30-4.45 and finishes at 6.00pm every Wednesday during School terms.                                                                    Personal Possessions: WPFC will not be held responsible for the loss of personal items or money.  Safeguarding Guidelines: Under the children’s act, staff are obliged to inform social services of any concern regarding a child. If there are any issues surrounding a member of staff the parent/carer are advised to inform the leader in charge, Geoff Biggs. If concerns related to the leader in charge, Westminster Safeguarding Unit should be notified on Tel: 0207 741 5909.                                                                                          Hygiene and health: Staff will not be held responsible for administering children’s medicine. If a child has an inhaler, then they will be allowed to treat themselves under staff supervision. If there are any concerns about a child’s state of hygiene of health, then parent/carers will be informed.                                                      By signing this form, you will also be giving permission for staff to seek emergency medical treatment of advice for your child if necessary Children’s behaviour: WPFC works hard to ensure that the children in care remain safe and comfortable. Therefore, if a child’s behaviour becomes unacceptable the parent/care will be contacted to collect their child. Parent/Carer Conduct: All parent/carers are requested to respect the environment of WPFC. If they are abusive to staff, shout or apply any form of physical force against a child or member of staff, then appropriate actions will be taken.                                                                                    GDPR: The general Data Protection Regulation effects the way in which charities keep information. Please see our privacy statement which explains what information we hold about adults and children who have registered with us. It also explains why we hold it, how we protect it, and how you can have information removed from our files. This can be found on our website at www.westbourneparkfamilycentre.org.uk. Westbourne Park Family Centre is a Christian Faith based organisation who welcomes children of all faiths and none. *I have read and agree with the above Child Care Policy
A copy of your responses will be emailed to the address you provided.
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