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Registration Form for Creative Space
We will be running a fun 4 days of activities at Kingsgate Church, Kingston, KT1 1QT, including cooking classes, art classes and music sessions. This programme is only open for 11-14 year olds.
Please note: There are only 32 spaces for this week which we will allocate to the first 11-14 year olds who apply.
We also hold all data in line with our data protection policy:
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* Indicates required question
Name of Parent/Guardian:
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Your answer
Contact Number:
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Your answer
Contact Email
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Your answer
Name of child(ren) e.g. Jane Brown
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Your answer
Date of Birth and age e.g. 1/1/10 (12) - This programme is only open for 11-14 year olds.
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Your answer
Gender of Child
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Female
Male
Prefer not to say
Other:
School child attends
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Your answer
Which day(s) would you like you child to attend? Please note that we would love children to attend all four days if possible (though not compulsory) to make the most out of the programme.
Monday 4th April
Tuesday 5th April
Wednesday 6th April
Thursday 7th April
Is your child on free school meals and is therefore eligible for a free space?
Yes
No
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Please detail any medical conditions, neuro-diversity, learning or physical limitations you feel we should be aware of: e.g. asthma, epilepsy, diabetes, allergies / dietary needs, dyslexia / dyspraxia, ADHD, autism, Down syndrome etc.
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Your answer
Please detail any way that the above condition(s) might impact on their learning and group-based work, or let us know how we can help make provision to support your child in their activities
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Your answer
Does your child have any medical allergies? Please note there is a further question around intollerance / dislikes. This question relates solely to medical allergies.
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Your answer
Does your child have any intollerances to any foods? Do they have dietary requirements?
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Your answer
Do you have any concerns about your child having access to sharp objects for cooking?
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Yes
No
If yes, please explain.
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Your answer
Is your child able to bring their own water bottle?
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Yes
No
Will you be picking up your child or can they can leave on their own?
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I will be picking them up
They will be leaving by themselves
Out of the following options, what do you think your child would enjoy? Please tick all that apply.
Learning the bass / guitar / ukulele
Learning the piano
Learning to play percussion instruments
Creative art activities
Cooking
Games
Do you give us consent to use photos, video clips and quotes in external Voices of Hope materials? We would love to publicise your children’s success!
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Yes I give permission.
No I do not give permission and I will speak to you to confirm this on the first day of activities.
Required
Would you be interested in receiving our monthly Voices of Hope newsletter?
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No
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