Term 4 Enrolment form (Online Course)
Please provide complete and accurate information and inform us of any changes. Communication regarding course groups will usually be via email or text.

We will be using a secure, closed Zoom account to carry out these sessions each week, details of the access codes will be emailed to you before the start of the sessions.

Your email is required in order to issue the weekly Zoom password, it will not be used for any other purpose unless consent is given in one of the questions below.
Email address *
Childs name *
Parent/Carer's name *
Childs date of birth (dd/mm/yy) *
Home address *
Postal code *
Gender *
Childs email (optional)
Childs mobile (optional)
Home phone number
Parent/Carer mobile number *
Mailing list consent
We would like to input your email into MailChimp (a company which complies with GDPR) in order to keep you updated with newsletters and relevant volunteering information? For further information about Mailchimp, please refer to this website address; www.mailchimp.com or to register yourself to receive the updates please visit http://eepurl.com/bQNXej to enter your details.
Mailing list consent *
Childs School/College *
Childs Year Group in September
Clear selection
Any other relevant information about child (i.e. plays an instrument, has singing lessons or requires additional support.
Does your child have access to a device they can log onto Zoom with? *
Does your child have the instrument required for the course? *
Do you need support with installing and setting up Zoom? *
Our music sessions starting 19.04.2021 - 05.07.2021 (we will break for half term 31.05.21)
Wednesday - 'The Mighty Write' Song Writing with Fuzzy 5.00-6.00
Sessions you wish to attend? *
We have a legal obligation to safeguard your child when they are in our care and even though we are delivering sessions online this obligation still stands. We ask that when your child is attending our online sessions an appropriate adult is in the room and aware that their child is online.
Do you agree to do this over the period of the Term? *
We may record some zoom sessions for promotional use or evidence to our funder of the work we are doing. If we are recoding for evidence purposes this will be passed to our funder and not shared with any other party.
Do you give consent for your child to be recorded? *
If you give permission to record your child for any use, please tick all categories for which you give consent *
Parent Information
This information will only be shared with our funder for evidence, it will not have your personal information attached to it, it is for statistical purposes only.
Are you in receipt of any benefits? *
If yes please state which *
Do you give consent for your child to attend our course? *
Thank you
The form is now complete and a member of the Cloth Cat team will be in contact to confirm if your child has a place on one of our courses.

Data Protection Act 1998 & General Data Protection Regulation. By signing this form, you are consenting to Cloth Cat Studios using the information to process your application for membership of the Get Your Act Together Courses. Your information will not be disclosed outside of Cloth Cat Studios without your consent, except where we are required to do so by law. Cloth Cat Studios is required to submit anonymised data to The National Lottery and will ensure compliance, in line with Cloth Cat Studios obligations under the Data Protection Act 1998 and the General Data Protection Regulation.

Cloth Cat Studios Ltd, The Old Chapel, 1 Crossland Court, Czar Street, Leeds, LS11 9PR. Tel: 0113 2442773 enquiries@clothcatleeds.org.uk. Cloth Cat Studios Ltd is registered with the Financial Conduct Authority as an Industrial & Provident Society for the benefit of the community, registered in England No. 28890R and as a charity with the Inland Revenue ref. XR31169
A copy of your responses will be emailed to the address you provided.
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