Sickle Cell Society - October Activities 2018

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Please sign up below for your child to take part in one (or more!) of our October activities. Please note that you will not need to stay with your child during most of the activities - there will be staff (Grace, Donna or Valerie) and volunteers to look after them:

Saturday 13th October
Capoeira Dance & Snack
1:00pm - 4:00pm
Kentish Town
*7+

Saturday 20th October
Mini Picassos - Arts and Crafts
3:00pm - 5:00pm
Kensal Rise
*5-12

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Siblings are welcome but children with sickle cell disorder get priority - depending on the activity sibling places may be confirmed at last minute.

Please make sure to sign your child in with a staff member when they arrive at an activity and to pick your child up on time. If you need to cancel your child's place, it is important to let us know as soon as possible so we can let a child on the waiting list have their place.

Places aren't guaranteed until we have given you confirmation as we have a limited number of places for each activity - you may end up on a waiting list. You will also need to fill in an additional medical form if this is the first time that you have taken part in a Sickle Cell Society activity.

We totally understand that sometimes due to illness or other unforeseen circumstances you need to cancel your child's place at an activity. As lots of our activities have limited spaces, please do let us know as soon as possible (48 hours before) if this is the case so that we can offer their place to someone else. This also means that we can make sure that all of the funding we have been given to spend on activities for your children is used most effectively (e.g. not spent on places that aren't used).

We look forward to meeting you soon!

Any information given on this form is securely encrypted (as shown by the 'S' in the web address - https), confidential and covered by the Data Protection Act 1998. If you would prefer to use a paper form, please e-mail grace.adejuwon@sicklecellsociety.org and we will send one across.

Child's Full Name *

Child's Date of Birth *

Child's Age *

Child's Gender *

Male

Female

Prefer not to say

Link to Sickle Cell: *

He/She has sickle cell

His/her brother or sister has sickle cell

His Mum or Dad has sickle cell

He/She has sickle cell trait

Required

(if not given before) Parent's Full Name

Parent E-mail address *

Parent Telephone number: *

(if not given before) Home Address:

Postcode: *

Hospital(s) your child attends: *

I would like to sign my child up for... (tick the box) *

Capoeira Dance workshop & Snack (13th October) - Kentish Town *7+ yrs

Mini Picassos Art and Craft workshop (20th October) - Kensal Rise *5-12 yrs

Required

Does your child have any support needs? (e.g. a learning difficulty, unsteady on their feet, uses a wheelchair?) If yes, please give us more details so that we can provide the right level of support during the activity *

Does your child have any allergies or additional medical conditions we need to know about (e.g. asthma, severe allergies etc). If so, please tell us below.

Do you have any ideas of activities we could run in the future? If so, please let us know below.

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