The Weir Link Arts and Design Club Registration Form

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The Weir Link, 33 Weir Road, London SW12 0NU
hello@theweirlink.org.uk
www.theweirlink.org.uk

We need this online form completed for each young person attending activities provided by The Weir Link. You will need to compete this form once per young person.

All the information required here will be stored in accordance with our Privacy Policy which is available at www.theweirlink.org.uk/privacy. The information you provide will not be given to third parties.

Email *

Please tell us how you heard about The Weir Link Arts and Design club? *

Word of mouth

Google/ internet search

Social media (Twitter/Facebook/Instagram)

Other:

YOUNG PERSON'S INFORMATION

Young Person's Full Name *

Young Person's Date of Birth *

Gender *

Female

Male

Name of School (from September 2023) *

Full home address including postcode *

Young person's mobile number (if appropriate)

Please send general texts with activity information to the Young Person (if appropriate)

Yes

Clear selection

Young person's email address (if appropriate)

Would you like us to email the young person with general activity information (if appropriate)

YOUNG PERSON'S MEDICAL & CONSENT INFORMATION

If the answer is 'yes' to any of these questions, please give details.

Does your child have any special dietary requirements or allergies? *

Does your child have a medical condition/disability/allergy? *

Does your child have any additional needs? *

Is there any other information which would be helpful for us to know about?

GP Details (Dr's Name, Address, Phone Number) *

I consent for my child to receive appropriate First Aid treatment (e.g. plasters and items found in a First Aid Kit) *

Yes

I give permission for my child to appear in photos and video that can be used for internal and external publicity and promotional purposes (e.g. website/social media). I understand that the identity of my child will be protected in all publications. *

Yes

PARENT/CARERS INFORMATION

Name of Parent/Carer A *

Home address of Parent/Carer A (if different to young person's) *

Mobile Number of Parent/Carer A *

Please send general texts with activity information to Parent/Carer A *

Yes

Home phone number of Parent/Carer A (optional)

Email Address of Parent/Carer A *

Please email general activity information to Parent/Carer A

Yes

Clear selection

Name of Parent/Carer B (optional question)

Mobile Number of Parent/Carer B (optional question)

Please send general texts with activity information to Parent/Carer B (optional question)

Yes

Clear selection

Email Address of Parent/Carer B (optional question)

Yes

Clear selection

Please send emails with activity information to Parent/Carer B (optional question)

Yes

Clear selection

Name and phone number of an alternative adult in case of emergencies (not a parent/carer) *

I consent to the details provided being added to The Weir Link's database for communication purposes. I understand that the information provided will not be given to third parties. For full details about how we use your data, please visit theweirlink.org.uk/privacy. *

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