Parent Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Child's Name

Date of Birth

Any allergies or dietary requirements (both attending adults and children)

Please tell us if there is anything you or your child will need to feel comfortable and supported at the group.

This might be formal additional needs or requirements such as neurodiversity, disabilities, etc. , or informal things such as needing a bit of extra time to process requests, opportunities for quiet space away from the group, etc! You can also use this space if there is anything else you think would be relevant to us in facilitating sessions for you and your child(ren). What things set your family up to do well?

I am signed up to the gocardless direct debit system.

please visit Gocardless to sign up as a direct debit customer.~ For children attending 1 day per week: https://pay.gocardless.com/BRT00039XYK6KD2 For children attending 2 days per week: https://pay.gocardless.com/BRT00039XYNSJVT

I am signed up!

Photography Permission

We ask that adults only take photos of themselves or their own children at the session. Leaders may use their company phones to take photos of activities either for record keeping or prootional purposes. please indicate your photo permissions below.

I'm happy for CotF staff to take photos during the session and understand that these may be used on social media or to advertise the company online

I'd would not like to myself or my children to be photographed