Please tick beside each day you wish your child to attend
Which Day will your child be attending *
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Medical Information
Does your child suffer from any medical conditions/ illness/ special needs/ disability or Allergies?
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If YES please provide more information
Your answer
GP Name and address
Your answer
GP Contact number
Your answer
Accident and/or Emergency consent form
I/We parent/guardian of above applicant give Mulhuddart Community centre my permission to obtain emergency medical treatment for my child when I cannot be reached or if a delay in treating my child would be dangerous for him/her
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Photography Policy
I/We parent/guardian of above applicant give permission for photos of our child/ren to be used by the centre for advertising purposes
Column 1
Newspaper/Newsletter
Facebook
Column 1
Newspaper/Newsletter
Facebook
Child Collection
Does your child have permission to leave the premises on their own to go home
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Other Authorized person to collect Child
Your answer
GDPR
General Data Protection Regulations (GDPR) requires us to have your consent to keep your information on file. Please tick Yes or No to show if you consent to any of the following.
Do you consent to Mulhuddart Community Centre keeping your details on file
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Do you consent to Mulhuddart Community Centre contacting you by phone/text/WhatsApp
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Do you consent to Mulhuddart Community Centre contacting you by Email
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If you would like to be contacted for future similar workshops or camps please tick here