Benwell Family Forest School Participant Info
Please complete this form with consent of the family you are referring/your details if you are completing this form yourself. Sessions run 10-12 on Fridays from Hodgkin Park
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Name, organisation and contact details of the person making this referral *
Name(s) of parent/carer *
Name(s) of children *
DOB of child(ren) *
Address of participant, including postcode *
Participant email address *
Phone number of participant
Emergency contact name and number
Family medical and dietary requirements
Please tick here to show that the parent/carer understands and agrees to our privacy policy. Stomping Grounds is registered with the Information Commissioners Office, Registration number ZA870463. Information you provide is used to ensure we meet the needs of participants whilst keeping everyone safe. Information is stored and used in line with our GDPR privacy policy which can be found on our website here: stomping-grounds.org/policies-and-procedures. Data collected for Equality and Diversity monitoring will be processed and used anonymously and will not be linked to your booking. Please tick here to tell us you have read our GDPR policy and agree to the storage and use of your personal information as laid out in the policy *
Required
Do you give consent for us to take photographs and video footage of you and your child? Images may be used on our social media platforms and shared with our funders. *
Do you consider yourself or your child to be disabled? This information is used for monitoring equality and diversity. By completing this section of the form, you support us to monitor equality, diversity and inclusion, to ensure we are representative of the communities that we serve. Please select all that apply from this drop down list *
Required
Child's Ethnic Group. This information is used for monitoring equality and diversity and will only be processed and used anonymously. By completing this section of the form, you support us to monitor equality, diversity and inclusion, to ensure we are representative of the communities that we serve Please choose one option that best describes your ethnic group or background *
Required
Child's Gender. This information is used for monitoring equality and diversity and will only be processed and used anonymously. By completing this section of the form, you support us to monitor equality, diversity and inclusion, to ensure we are representative of the communities that we serve Please choose all that applyUsed on 30 entries *
Required
The reason you are making this referral. Please give us some information about why you feel this group may be beneficial to this family, and any current barriers they face to engagement in cultural and outdoor activity. *
Will the family require support with transport to the site? *
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