Enrich Education - Super Saturday Sessions - Registration Form
Session Location (Area) *
Session Content *
Child’s Name *
Child's School *
Child's Current Year Group *
Home Address *
Post code *
Parent / Guardian Full Name *
Contact Phone Number: *
Emergency Contact Name: *
Emergency Contact Phone Number: *
Email Address: *
Does your child suffer from any of the following medical conditions? *
Required
Are they currently taking any medication? Please provide details:
Any known allergies (e.g. Penicillin) Please provide details:
Does your child suffer from any other relevant illness, injury or condition? (Please indicate if child receives additional support in school):
Will your child be: Collected from activity location by an adult ? *
Parent/Carer Declaration: I consent to my son/daughter taking part in the Enrich Education session and the information I have supplied is correct. In the unlikely event of an accident occurring when I cannot be readily contacted, I give permission for the on site coordinator to authorise emergency medical, surgical or dental treatment, including anaesthetic or blood transfusion, if deemed necessary by the medical authorities present. *
I give permission for photographs to be taken of my child to be used in the future for Enrich Education promotional materials. *
I would like to receive information regarding future programmes and products through Enrich Education *
*All data provided on this form will be processed in accordance with our privacy policy & GDPR (Nov 2019). Further information and our full privacy policy can be found here:
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