HAF Easter Booking Form

FREE Holiday Activity Form Easter 2023

Booking Form

If you have more then one child that to sign up please complete a separate form for each child.

Child's full name

Age

Child’s date of birth

Does your child have a free school meal?

WHITE ETHNICITY/CULTURAL BACKGROUND

English / Welsh / Scottish / Northern Irish / British Irish Gypsy / Irish Traveller

BLACK ETHNICITY/CULTURAL BACKGROUND

African Caribbean

ASIAN ETHNICITY/CULTURAL BACKGROUND

Indian Pakistani Bangladeshi Chinese

MIXED ETHNICITY/CULTURAL BACKGROUND

White / Black Caribbean White / Black African White / Asian

OTHER ETHNICITY/CULTURAL BACKGROUND

Arab Other

School child attends

Parent/Guardian Name

Parent/Guardian Email Address

Parent/Guardian Contact Number

Parent/Guardian Full Address & Post Code

Emergency Contact Details if different from above

Ages 7 - 11- Please tick the venues and weeks that you would like you child to attend.
*You are able to attend more than one week*

Clipstone Youth Club, Church Road, Clipstone, NG21 9DF: 3rd - 6th April 10am - 2pm (Nottinghamshire) Cotgrave Club Woodview, Cotgrave, Nottingham, NG12 3PJ: 11th - 14th April 10am - 2pm (Nottinghmashire) Bestwood Estate Community Centre, Gainsford Crescent, Bestwood, Nottingham, NG5 5HT: 11th - 14th April 10am - 2pm (Nottingham City)

Ages 11 - 16- Please tick the venues and weeks that you would like you child to attend.
*You are able to attend more than one week*

TBC

Please note that each Release Club lasts 4 days culminating in a showcase of their work throughout the week. We encourage children to attend all sessions.

Where did you hear about the Freedom Foundation Release Programme from?

Please share any further comments for the above question

Does your child have any dietary requirements?

Yes No

If yes to above question please state

Does your child have any allergies?

Yes No

If yes to above question please state

Does your child have a disability or health condition?

Yes No

If yes to above question please state

Is your child taking any medication?

Yes No

If yes to above question please state

Will your child need help to take their medication during the sessions?

Yes No

If yes to above question please state what help they need and when

Is there any other information we should know about your child ahead of the sessions?

How will your child get home after each session?

Walk home alone On public transport alone Collected by parent/guardian

Please provide details of the person collecting your child if it is not you

I confirm that I am the parent/guardian of the child mentioned above and I give permission for Freedom Foundation to film and record my child for promotional purposes.

You can withdraw image consent at any time by contacting info@freedomfoundationuk.org or calling 0115 9932370.
A copy of the Freedom Foundation Photography and Filming policy is available on request.

I consent to Freedom Foundation processing this personal data to achieve their educational aims according to the privacy policy

You can withdraw consent at any time by contacting info@freedomfoundationuk.org or calling 0115 9932370.

Name

Date

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Contact details

Freedom Foundation Contact Details Antenna, 9a Beck Street, Nottingham, NG1 1EQ

Tel: 0115 9932370

Email: info@freedomfoundationuk.org

FREE Holiday Activity Form Easter 2023

Booking Form

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