Coding: Expression of Interest
Balgaddy Child and Family Centre 2024
Adult/Guardian Details: Name
*
Full Name
Contact Number:
*
Please enter a valid phone number.
Email
*
example@example.com
Area you live?
*
Tallaght
Clondalkin
Lucan
Child's Details
*
First name
Last name
Date of birth
*
-
Month
-
Day
Year
Date
When the club is over my child
*
Can walk home alone
Will be collected by a family member or friend
I give permission for my phone number providedto be added into a WhatsApp group for the purpose of exchanging informationabout the club
*
Yes
No
I give permission for my son/daughter’s photo tobe taken for the purpose and promotion of this programme. Some photo’s may beposted on centres Facebook page.
*
Yes
No
Submit
Should be Empty: