Club Xpress Registration Oct 23-July 24

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Please complete this form to register your child for Club Xpress during the school year 2023-2024.

Club Xpress is for any child aged 4-11 years old.

We will also use these details for any other occassion your child attends to reduce the number of times you need to fill in a registration form.

We are asking more questions that normal as want to measure the impact of our work in providing activities and clubs for your children. At the end of the year we will ask the questions again to review progress in these areas.

If you have any questions please contact: Geoff Biggs on
Tel: 0794110076 or Email: geoffbiggs@westbourneparkfamilycentre.or.guk.
Address: Westbourne Park Family Centre, Westbourne Park Baptist Church, Porchester Road, London, W2 5DX. Charity no: 1085070

Email *

First Name of child/youth *

Surname *

Parent/Carer mobile number *

Home Address *

Post Code *

School Year *

School *

Date of Birth *

We welcome young people from all faith backgrounds and none. Please tick as appropriate *

Christian

Muslim

Hindu

No Faith

Other:

Required

We welcome young people from all ethnic groups and nationalities. Please tick as appropriate *

White

Black, African, Caribbean or Black British

Asian or Asian British

Mixed or Multiple Ethnic Groups

Prefer not to say

Other:

Required

Westbourne Park Family Centre is a Christian based charity with values to: (THINK) Trust, Hope, Inspire, Nurture and be Kind

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