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Footprints Registration Form
Welcome! Lovely to have you here. Please complete the following information to register your interest and child(ren) with Footprints. If you are registering multiple children, you will need to fill out this form once for each child. Looking forward to meeting you and your lovely little ones!
Email address *
Would you like to opt in to our mailing list for news and offers? (You are free to unsubscribe at any time) *
Main contact phone number and name *
Your answer
Child's Name *
Your answer
Child's Age and D.O.B *
Your answer
I am registering my child, for the following class(es) *
Required
Please confirm the following *
I will be collecting my child each week, after class, from the YMCA main lobby entrance inside (please inform us via phone, before class, on 07895425840 with the details of who is due to collect your child)
Required
Please confirm the following *
I give permission for my child(ren) to be photographed/filmed for the purpose of promoting Footprints publicly on the Footprints website, on social media pages and for Bournemouth Foodbank publications.
Required
Please confirm the following
I give permission for my child to participate in community events and public performances
Please use the space provided below, to inform us of any medical conditions, allergies or allergens
Your answer
Please use the space below, to inform us of any additional needs or emotional, social, physical or behaviour support that may be required for your child
Your answer
Next of kin contact name *
Your answer
Next of kin contact relation to child *
Your answer
Next of kin contact number *
Your answer
Signed (Type your name) *
Your answer
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