SMART (NI) SUMMER SCHEME 2025
REGISTRATION & CONSENT FORM
CHILD 1
First Name
Last Name
Please Insert Your Child/Children's Name(s) Below
Child 1 Age
CHILD 2
First Name
Last Name
Child 2 Age
CHILD 3
First Name
Last Name
Child 3 Age
CHILD 4
First Name
Last Name
Child 4 Age
Please Insert Parent or Guardian's Name Below
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Tel Number
Allergies or Medical Conditions
Has your child any allergies or medical conditions?
Yes
No
If your child/children have any allergies or medical conditions, please provide details below
If you have any further information regarding your child/children's health, safety and well-being, that you think we need to be made aware of, please provide details below.
PHOTOGRAPHS
Do you consent to photographs being taken of your child by SMART(NI) at the Summer Scheme?
Yes
No
If you do consent to photographs being taken by SMART (NI), can they be posted on our Facebook page?
Yes
No
Note
Please provide a small packed lunch and drink for your child/children. Please provide suncream, summer hat(s), raincoat(s)/jacket(s) as per weather conditions each morning. Please also ensure that your child wears tracksuit bottoms instead of shorts if possible and that all footwear is easily taken on/off as this may be required for some activities.
PRIVACY NOTICE & GDPR
SMART (NI) will store and use your personal data exclusively for the purposes of administering the SMART (NI) Summer Scheme 2025. By submitting this form you consent to your data being used solely for that process and you understand that it will not be shared with anyone else.
DECLARATION OF CONSENT
Please type your own name in the box below to confirm you have read & understood the information supplied in the form and that you consent to your child or children named, attending the SMART (NI) Summer Scheme from 10am to 2pm on the 22nd and 23rd August 2024.
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Submit
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