Bright Sparks – Play, Learn, Grow Together
MSCNI Early Learning & Family Empowerment Project - Phase 2 starting March 2026
Children & Young People Registration Form (Ages 5-13) Funded by LFT Charitable Trust, supported by Belfast City Council
1. Child's Details
Child's Full Name:
Date of Birth:
-
Month
-
Day
Year
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Age:
5
6
7
8
9
10
11
12
13
Gender (optional):
Male
Female
Prefer not to say
2. Parent / Guardian Details
Parent / Guardian Full Name:
Relationship to Child:
Contact Phone Number:
-
Area Code
Phone Number
Email Address:
example@example.com
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Home Address / Area (optional):
3. Preferred Programme Location
Please tick one preferred centre:
South Belfast
East Belfast
West Belfast
North Belfast
4. Preferred Days & Time
Sessions run 4:00pm - 6:00pm
Please tick all days that suit you:
Monday
Wednesday
Thursday
Friday
5. Activities You Are Registering For
Please tick all that apply:
Learning & Education
Transfer Test Support
Homework Club
Sports & Physical Activities
Sports & Games
Team Activities
Culture & Creativity
Cultural Activities
Arts & Crafts
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6. Additional Support Needs (Optional)
Does your child have any additional needs, learning support requirements, allergies, or medical conditions we should be aware of?
Does your child have any additional needs, learning support requirements, allergies, or medical conditions we should be aware of?
Yes
No
If yes, please provide details:
7. Emergency Contact
Name:
Phone Number:
-
Area Code
Phone Number
Relationship:
8. Consent & Declarations
I confirm that the information provided is accurate to the best of my knowledge.
I give consent for my child to participate in the Bright Sparks - Play, Learn, Grow Together programme delivered by MSCNI.
I understand that MSCNI will handle personal data in line with GDPR and its Data Protection Policy.
I consent to my child taking part in sports, cultural, and creative activities as part of this programme.
I understand that photographs/videos may be taken for monitoring, reporting, and promotional purposes (optional):
Yes
No
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9. Signature
Parent / Guardian Name:
Date:
-
Month
-
Day
Year
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Submit
Should be Empty: