Community House Workshops/Activities 
April - May 2023 - Please fill in this form if you would like to attend the workshops/activities this term 
Sign in to Google to save your progress. Learn more
Email *
Your Name: *
Your Date of Birth  *
MM
/
DD
/
YYYY
Telephone Number *
GP Surgery Name ( Please only complete if you are attending Keep Fit) The class is funded by Healthy Island Partnership
Child 1 : Name, Date of Birth & Class *
Child 2: Name, Date of Birth & Class
Child 3: Name, Date of Birth & Class
Child 4: Name, Date of Birth & Class Name
Child 5: Name, Date of Birth & Class Name
Please tick the box for the activity/activities  you would like to attend.  *
Required
GDPR - The information collected on this form will be used in compliance with General Data Protection Regulations. By supplying information, you are giving your consent to the information being used for the schools monitoring and funding purposes for activities that are provided within the Community House. This information will be kept strictly confidential and will be deleted in accordance with the Retention Guidelines for schools.
September 2022
Today's Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Cubitt Town Junior School. Report Abuse
Google Forms