Bowes Club Registration Form

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All applications need to be completed using this form.

First Name *

Childs Surname *

Class *

Date of Birth *

YYYY

Gender *

Female

Male

Home Address (including postcode) *

Parent 1 - Name & Telephone Number *

Parent 1 - Parental Responsibility? *

Yes

Parent 1 Home Address - If different to child: *

Parent 1 - email address *

Parent 2 - Name & Telephone Number

Parent 2 - Parental Responsibility?

Yes

Clear selection

Parent 2 Home Address - If different to child:

Parent 2 - email address

Specific collection arrangements *

Please state a password to be given to the Bowes Club staff for when your child is collected *

Emergency Contact: (You must provide two contacts) *

Siblings - Name / Date of Birth / Male or Female / School and Class

Dietry Requirements: (please specify) *

Diabetic

Vegetarian

Allergy to foodstuff

Other

None

Required

Child's needs: (i.e Physical/Learning/Behaviour/Emotional please specify)

Appendix 1 *

I give consent

I do not give consent

I agree that any digital media (photograph or video images that I take at school events will be for my own personal use and will not be used inappropriately or shared with third parties). *

Yes

Appendix 2 *

I have shared this Acceptable Use Agreement with my child at an age appropriate level

Required

Appendix 3 *

I give consent

I do not give consent

Please indicate in the table below the days you would like your child to attend Bowes Club.

Monday

Tuesday

Wednesday

Thursday

Friday

Breakfast Club

After School Club

Please enter the required start date *

YYYY

Clear form

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