2021/2022 FUN CLUB Registration Form CONFIDENTIAL

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This form can be used by parents and carers booking Fun Club for a child who attends The Mary Bassett Lower School. The reason we ask for this information, how we keep the information secure and who we share it with, is detailed in the School Privacy Notice which is on the School Website.

If you need any guidance, assistance with completing this form or further clarification, please ask a member of the School Office to help you.

Personal Details of Pupil

Surname: *

Other Names: *

Preferred known name:

Date of Birth: *

Pupil's Home address (including postcode) *

Name of any other children you have registered for Fun club?

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