This Girl's Ability Pop Culture Club (Havering)
Leave your details to register your interest for our monthly Pop Culture Club (Fashion, Arts and Crafts, Movies, TV, Music & Books). Our sessions are for girls and young women with disabilities aged 12-25.
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Parent/Guardian/Support Workers Full Name
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Young Person's Name
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Young Person's Age
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Young Person's Disability
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Contact Number
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Contact Email Address
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Postcode
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Where did you hear about us?

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Which pop culture themes are you interested in? (tick as many as you like) You are welcome to share a theme in the other box (e.g. Harry Potter, Cobra Kai, etc.) 
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