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LOVELAND HOLIDAY ACTIVITIES AND FOOD CLUB
Contact details:
lovelandchildcareservices@gmail.com
FUNDED BY DEPARTMENT OF EDUCATION FOR CHILDREN ELIGIBLE FOR FREE SCHOOL MEALS.
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Child's Information
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First Name
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Your answer
Last Name
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Your answer
Age Group
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14- 16years
Date of Birth
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MM
/
DD
/
YYYY
What Gender do you associate with
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Boy
Girl
Other
Name of School
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Your answer
Ethnicity
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White British
White Irish
Gypsy or Irish traveller
Any other white background
Caribbean
African
Any other black ground
Indian
Paskistani
White and Asian
Any other mixed/ multiple ethnic background
Bangladeshi
Chinese
Any other Asian background
Arab
Other
Does this child or young person receive free school meals
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Yes
No
Are you known to the local authority or supported by social services
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Yes
No
Does your child fall under SEND (Special Educational needs and disability.)
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Yes
No
Does your child/young person have any allergies or dietary requirements?
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Yes
No
If yes, please specify to ensure we provide the support your child needs
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If yes, does your child/young person have an education and health care plan at school?
Yes
No
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Is there any taking medication your child is taking that we need to be aware of? please indicate
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Please provide GP Information
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