Name of child / young person *

First Name

Last Name

Is participant looked after child / under special guardianship? *

Yes

No

Is participant a refugee / asylum seeker child? *

Yes

No

Does the participant have SEND / additional support needs? *

Yes

No

If yes, please sepecify

Select from the following

Communications and interaction difficulties

Cognition and learning difficulties

Social, emotional and mental health difficulties

Physical and / or sensory needs

Is the participate registered on the Free School Meals Register? *

Yes

No

Does the participate live or attend a school in the London Borough of Lambeth? *

Yes

No

If you have selected yes for the above questions, the participant is entitled to 1 of the 20 free places if all have not been taken up. Will you be prepared to provide reasonable evidence? *

Yes

No

N/A

Does the participate have any disabilities? *

Yes

No

In addition to completing this initial registration form, you will be required to complete our Covid-19 questionnaire as part of the welcoming process. Do you agree to complete this questionnaire to ensure that all Covid-19 risk plan actions will be followed? *

Please note that if you do not agree to this process, we will not be able to register your child / children onto this programme due to Covid-19 requirements

Yes

No

Please select all relevant options where you consent for your child's image to appear in video clips and still shots for marketing and training purposes (see below for more details) *

BiG C.I.C will be recording and taking pictures of many of the activities during this programme for training and marketing purposes. We will use recordings to edit and produce marketing films and these and still images will be posted on the BiG C.I.C. website, other social media platforms, and published in promotion / training material.

I do not consent

Website

instagram

Twitter

Facebook

Youtube Channel

Promotion material

Training material

I consent to all