Antur Bach Nature Club
REGISTRATION FORM
Date
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Month
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Day
Year
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Parent/Guardian's name and relationship to child
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Full Name
Relationship
Child's Full Name
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First Name
Last Name
Child's Date of Birth
*
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Month
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Day
Year
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Child's Full Name (sibling)
First Name
Last Name
Child's Date of Birth (sibling)
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Month
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Day
Year
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Emergency Contact Name and Number
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Name
Number
E-mail
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example@example.com
We may occasionally take photographs/videos for publicity and promotion (including posting on social media). If you permit photographs to be taken of the child in your care for such purposes, please select the boxes below.
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Yes
No
Some activities may contain elements such as nuts, seeds and other allergens. Please state if you or your child have any allergies
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ALLERGY NOTICE: Due to the high volume of registration forms submitted at different times, please contact Antur Bach directly through email or social platforms to inform of you or your child's allergy before attending a session. This will ensure activities are adjusted for your safety.
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I have read and agree to the above
I, the parent/care giver take full responsibility for the child in my care. Antur Bach Nature Club will not be held responsible for the well being of the child in my care in the case of an injury or an accident.
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Please check this box as consent to the above statement
Privacy Notice & Data processing info. You are FREE to NOT give consent to the following and still attend our sessions. Please check any of the consent boxes you agree with.
I give consent for the name and date of birth of child, my name and the emergency contact number to be kept to be used in the event of an emergency
I give consent for Antur Bach Nature Club to keep my Name, address, email and phone number for the purposes of making me aware of future events or activities or changes to regular events
I give consent for Antur Bach Nature Club to keep my Name, address, name and date of birth of child for legitimate interests of Antur Bach Nature Club as a small business E.g analyzing statistics relating to our users to assess how Antur Bach can improve its services in the community
Legal Stuff you need to know.. Antur Bach Nature club will never share your personal data with any other groups or individuals. You can withdraw your consent to us holding your information at any time, by speaking to Gabi Thomas or calling the phone number or email address provided. We will respond within one month and confirm that we have deleted or destroyed your information. We will hold your consented Emergency information for 12 months after you have stopped regularly attending the group, then we will safely delete and or destroy the emergency details we hold. We will hold information consented for promotion of events and statistics for 36 months after you have stopped regularly attending the group.
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I have read and understand the above
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