Child Enrolment Form

CHILD ENROLMENT FORM

* Indicates required field, which must be entered to submit form. Please also note that this form must be filled and signed by the parent or guardian of the child.
Name of Course or Activity*
Start Date

DayMonthYear
Date
End Date

DayMonthYear
Date
Day
Term
Child / Young Person's Full Name*
Date of Birth*

DayMonthYear
Gender*
School Year*
School
Child's First Language
Child's Address*

Street Address Line 1

Street Address Line 2

TownCounty

Postocde
Parent's / Guardian's Full Name*
E-mail of Parent / Guardian*
example@gmail.com
Parent's / Guardian's Mobile No.*
Parent's or Guardian's WhatsApp Number (If different to Mobile No.)
Parent / Guardian preferred language
Parent with communication difficulties
Ethnicity*

White -English, Welsh, Scottish, Northern Irish or BritishWhite - Gypsy or Irish TravellerWhite - IrishWhite - RomaAny other White backgroundMixed or multiple ethnic groups - White & Black CaribbeanMixed or multiple ethnic groups - White & Black AfricanMixed or multiple ethnic groups - White & AsianAny other Mixed or multiple ethnic backgroundAsian or Asian British - ChineseAsian or Asian British - BangladeshiAsian or Asian British -PakistaniAsian or Asian British - IndianAny other Asian backgroundBlack, Black British, Caribbean or African - CaribbeanBlack, Black British, Caribbean or African - AfricanAny other Black, Black British or Caribbean backgroundOther ethnic group - ArabOther
Please specify your ethnicity if you chose 'Other' above:
Medical Questionnaires:

Please answer all questions by ticking the appropriate box
1. Does your child have a medical condition requiring medical treatment or medication? *
2. Does you child have an allergy to certain medications? *
3. Are your child able to administer his/her own medication?
4. a) Does your child have any food allergy? *
4. b) If your child has food allergy, please give details below
5. Please give details of any other medical condition/ treatment or allergies you may have:
6. a) Have your child been in contact with any contagious or infectious diseases or suffered from anything in the last four weeks that may become contagious or infectious?
6. b) If you answered 'Yes' to Que 6. a), please give more details below:
Emergency Contact Information: (Please provide names, Tel no. and relationship of 2 people who can take care of the child in case of emergency situation) *
Please provide Full Name, Tel No, & Relationship with children of each of the 2 persons for emergency contacts
Family Doctor's Name (Child's GP / Surgery), Tel No & Address:
Terms & Conditions for children activites / courses:

1. A firm commitment is required both from you and the child to attend this course on a regular basis. We expect you to inform us in advance if a child is not able to attend due to ill health or other unavoidable circumstances. If a child misses a session without any prior notice, they will be withdrawn from the service without giving any notice.

2. For promotional purpose, from time-to-time we may require to take photographs & video footage of the activity your child will be attending. This means we might be using your child’s image in our publicity materials. Please note that your child’s details will not be passed to any other agency. Please tick the box below if you don’t wish your child to be photographed or their images to be used for these purposes. **

3. It is expected that your child will be at their best behaviour when attending the activity. If they involve in any activity which is perceived to be interruptive to the session, they will be immediately withdrawn from the service without any warning.

We hereby agree to follow and accept all above terms and conditions.

The information on this form will be solely for Forum’s use, we will not pass the information to anyone else. We may contact you to inform of our other services which might be beneficial to you. We may hold this information for a particular period after which it will be destroyed. By signing this document, you are giving us consent to keep your information in our record and also to contact you in the future. You also agree that you have read NHMEF privacy notice (please see the page overleaf). You have the right to can this consent form anytime by giving us a written notice.
* Following Point No. 2 in the above 'Terms & Conditions' section, please tick this box below if you don’t wish your child to be photographed or their images to be used for these purposes.

I don't wish my child to be photographed or his/her images to be used
Additional Comments (if any)
Agree and consent to Privacy Notice*

I agree (Please expand and read the "Privacy Notice" below before clicking "I agree".)
Signed (by parent / guardian of child)
Type your name
Date Signed

DayMonthYear
Date
North Herts Minority Ethnic Forum (referred to in document as NHMEF)

Privacy Notice

When you contact us

The information you provide (personal information such as name, address, email, phone no) will be processed and stored so that it is possible to contact you, provide information and/or access our facilities and services. Your personal information won’t be shared or provided to other 3rd party.

NHMEF right to Process Information

General Data Protection Regulation (GDPR) Article 6 (1) (a) (b) and (e) allows us to hold and process information if: Processing is with consent of the data subject, or Processing is necessary for compliance with a legal obligation, or Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller

Information Security

NHMEF ensures the security of personal data or information is protected from unauthorised access, loss, manipulation, falsification, destruction or unauthorised disclosure. This is done through appropriate technical measures and appropriate policies. We will only keep your data for the purpose it was collected for and only for as long as is necessary. After which it will be deleted.

Children

We will not process any data relating to a child (under 13) without express parental/ guardian consent of the child concerned.

Your Rights

Access to Information

You have the right to request access to the information we have on you. You can do this by contacting our Data Information Officer: director.nhmef@outlook.com

Information Correction

If you believe that the information we have about you is incorrect, you may contact us so that we can update it and keep your data accurate. Please contact: director.nhmef@outlook.com

Information Deletion

If you wish NHMEF to delete the information about you please contact: director.nhmef@outlook.com

Right to Object

If you believe that your data is not being processed for the purpose it has been collected for, you may object: Please contact director.nhmef@outlook.com

Rights Related to Automated Decision Making and Profiling

NHMEF does not use automated decision making or profiling of individual personal data.

To Sum Up

In accordance with the law, we only collect a limited amount of information about you that is necessary for correspondence, information and service provision. We do not use profiling, we do not sell or pass your data to third parties. We do not use your data for purposes other than those specified. We make sure your data is stored securely. We delete all information deemed to be no longer necessary. We constantly review our Privacy Policies to keep it up to date in protecting your data.

Complaints

If you have a complaint regarding the way your personal data has been processed you may make a complaint to Please contact director.nhmef@outlook.com and the Information Commissioner’s Office: casework@ico.org.uk, Tel: 0303 123 1113
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CHILD ENROLMENT FORM