Caregiver Booking Form
This form should take under five minutes to complete.

Privacy Statement: Artburst collects anonymised information for monitoring purposes and to contact families in the event of a change in programming. For a copy of Artburst’s Data Protection Policy please email info@artburst.co.uk. You may request to see the data we hold on you by emailing us to make an appointment.
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Your name
Your number
Your email *
Please tell us your postcode *
It would help us to know: *
Yes
No
I would rather not say
I'm not sure
Is your child on free school meals?
Does your child have special educational needs?
Does your child have speech, language and communication needs?
Is English your first language?
Do you receive universal credit?
Your child's name
Your child's date of birth
MM
/
DD
/
YYYY
To help us support you and your child please let us know if either of you have any additional access needs
Which workshop would you like your child to participate in?
3rd May
10th May
17th May
24th May
Artburst Boogie 10:00 - 10:30 (under 5s with parents/caregivers) starting on Friday 3rd May
Artburst Make & Paint 11:00 - 11:45 (under 5s with parents/caregivers) starting on Friday 3rd May
Artburst After School 15:45 - 16:45 (5 - 8 year olds drop off) starting on Friday 3rd May
If your child is NOT attending the Artburst After School then please skip to to section 2 of this form
Emergency contact name and relationship to child
Emergency contact number and relationship to child
Section 2: Confirming your place
Workshops are free to attend but to secure your place you must fill out this form. 

If you are able we welcome a voluntary donation via our donations page for each session you would like you/your child to attend.

Spaces are limited so be sure to press submit at the end of this form!

Is there anything else you would like to share?
Where did you find out about these workshops?
Workshops are running at Holdspace, Risinghill Street N1 9SY
If you do not hear from us please assume have a space 😊
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Thank you!
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