Child's Full Legal Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Parent/ Guardian/ Carer's Name *

First Name

Last Name

Child's Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Is the child eligible for free school meals? *

Yes

No

Is the child a refugee or asylum seeker? *

Yes

No

What dates can the child attend? *

Tuesday 2nd April

Wednesday 3rd April

Thursday 4th April

Friday 5th April

Sharing information with the council *

We will be sharing a limited amount of data with Westminster City Council as part of the monitoring requirements for this programme. This information will include your child’s date of birth, school and full name. This information will be matched with school census information to monitor eligibility and reach of the Holiday and Activity Fund Programme. If you have any questions about this please visit: https://www.westminster.gov.uk/children-and-education/westminster-youth-connected

I agree to share identifiable information with the council.

Photo Consent *

Occasionally, we take photos during the activities we run. We would be grateful for your permission to take photos of your child and use these in our printed and online publicity for the Floating Classroom and Puppet Theatre Barge. This might include (but is not limited to) our printed and online publicity, social media, press releases and funding applications. Our funders may also use these images for their promotional material. You are not required to provide photo consent, and we will ensure that no images of your child are stored or used by the charity if you do not provide your consent.

I grant The Floating Classroom and The Puppet Theatre Barge full rights to use the images resulting from the photography of my child, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the charity’s aims.

I do not grant permission to use images resulting from the photography of my child.