New Customer Registration Form

Registration Form:
Child's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postcode
Date of Birth

MonthDayYear
Date
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
How did you hear about us?
Other

People authorised to collect your child from the venue:

Rows	Name:	Relationship:
1
2

Photograph and Video Consent

African Maua recognises its responsibility to ensure the welfare and safety of children and young people and to comply with the General Data Protection Regulations 2018. We use photographs and videos to promote our activities. Photographs and videos will only be recorded by our director and will not be kept for longer than is to be considered necessary.

African Maua will:

a.     ensure that the photos and images are only used on the African Maua’s website and social media sites (Instagram, Facebook).

b.     not disclose children’s identity.

1.     I confirm that my child’s image may appear on our website and our social media site.

2.     I understand that I have the right to withdraw consent at any time by contacting African Maua.
Any food allergies/diet requirements Type a label
Signature
Should be Empty: