Oasis Family Support Registration
By filling in this form, you are giving permission for Oasis Hub Waterloo to store and access your details* to contact you about relevant services or support that we offer regarding support for individuals and families. This includes those already within the Oasis network, as well as any external registrations.

Oasis Hub Waterloo will then follow up with the individual seeking support, to assess and identify how we can work together with you/them to positively progress their situation.

If you are filling this out on behalf of another person, you must identify that they have given consent for you to fill this out on their behalf.

*We will hold your data in line with data protection regulations, and you can request to withdraw consent at any time by emailing welcome@oasiswaterloo.org 
Our privacy statement can be viewed on our website www.oasiswaterloo.org & www.oasisuk.org/privacy-policy
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Name of individual registering (Parent, not staff member) *
Are you filling this form in yourself? *
If no, please identify your name, email and relationship to the individual (teacher, friend, doctor etc.)
Please confirm you are the individual filling in this form, or have received  consent from this indvidual to register their details. Please continue to fill in this form with the details of the individual registering. *
Phone number *
Please identify any areas of support that are relevant
Any additional comments/information
How many adults are in your home?
How many children are in your home? Please include ages.
Child(ren) school names
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