• Walker Children's Club Registration 

  • Child's Information

  • Address where child is resident

  • Male or female?*
  • Date of Birth*
     / /

  •  First Parent/Guardian's Information 

  • Is your address the same as the child's address?*

  •  Second Parent/Guardian's Information

  • Is your address the same as the child's address?

  • Emergency Contacts.

    Please provide the details of 2 people, other than yourself, who can be contacted to collect your child at short notice in the event of an emergency

    Emergency contact 1: 

  • Emergency Contact 2:

  • We will automativcally assume that the parents/guardians and emergency contacts listed above are authorised to collect the child from WCC. Please list here any other people who you authorise to collect up the child from WCC

  • Medical information

  • Are there any health conditions of which we should be aware? *

  • Consent for Medical Treatment

    In the case of emergency, I consent to my child receiving medical treatment if WCC staff or a doctor think that it is required and I cannot be contacted following reasonable attempts to do so. 

  • Date consent given*
     / /

  • Permissions 

  • Rows

  • WCC Policies and Procedures including Data Protection Policy and Data Privacy notice are available on our website Walker Children's Club

  • Should be Empty: