Oasis Family Support Registration

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By filling in this form, you are giving permission for Oasis Hub Waterloo to store and access your details* to contact you about relevant services or support that we offer regarding support for individuals and families. This includes those already within the Oasis network, as well as any external registrations.

Oasis Hub Waterloo will then follow up with the individual seeking support, to assess and identify how we can work together with you/them to positively progress their situation.

If you are filling this out on behalf of another person, you must identify that they have given consent for you to fill this out on their behalf.

*We will hold your data in line with data protection regulations, and you can request to withdraw consent at any time by emailing welcome@oasiswaterloo.org
Our privacy statement can be viewed on our website www.oasiswaterloo.org & www.oasisuk.org/privacy-policy

Name of individual registering (Parent, not staff member) *

Are you filling this form in yourself? *

Yes

If no, please identify your name, email and relationship to the individual (teacher, friend, doctor etc.)

Please confirm you are the individual filling in this form, or have received consent from this indvidual to register their details. Please continue to fill in this form with the details of the individual registering. *

Yes

Postcode

Borough

Phone number *

Please identify any areas of support that are relevant

Crisis intervention/prevention

Food insecurity

Financial pressure - including low income, debt or risk of debt

Housing issues

Relationship/family challenges

Employability

Practical and hardship support (ranging from access to our baby clothes bank, to white goods/household essentials etc)

Emotional and pastoral support

Community engagement, activities and support (isolation, finding a support network, accessing opportunities)

Health and wellbeing

Other:

Any additional comments/information

How many adults are in your home?

How many children are in your home? Please include ages.

Child(ren) school names

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