Questionnaire on activities

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Which activity are you signing up for? *

Black History Month Scavenger Hunt - 1st - 31st October 5-11 years

Black History Month Scavenger Hunt - 1st - 31st October 12-17 years

Black history month workshop and storytime - October 31st 6-17 years

Festive rehearsals and performance - 7th November - 19th December 8-17 years

New years event- arts and crafts and healthy living workshop - 16th January 5-17 years

Internet safety - 6th February 5-12 years

Cooking workshop - 16th February 5-12 years

Parent/carer's full Name? *

Parents telephone number *

Child's Full name? *

Child's gender? *

Female

Male

Prefer not to say

Child's age? *

Child's date of birth? *

YYYY

Home address *

Postcode *

Link to Sickle Cell *

He/She has sickle cell

He/she brother or sister has sickle cell

His/her mum or dad has sickle cell

He/she has sickle cell trait

Hospital(s) your child attends *

Would you like to volunteer with us? *

Yes

Maybe

Do you have any ideas on what activities we can do in the future? If so then let us know

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