Registration Form for Daniel’s Den

Why register?

If you have a child/ren under 5 years of age and would like to join our sessions, please complete our Registration Form. This will help us to send you relevant information relating to the Daniel's Den session you are interested in. If you have any queries, our email address is: info@danielsden.org.uk

I am interested in attending the following session*

Please select a session venue

Name*

FIRST Name of Parent/Carer SURNAME of Parent/Carer

Parent/Carer Gender*

Female
Male

Address line 1*

Address line 2

City

Borough

Post code*

Contact details

Please provide us with a telephone number and email address, so we can keep you informed of any updates or last minute session changes. Thank you and remember you can withdraw your consent for contact at any time.

Mobile Tel number

Home Tel number

Email address*

All our sessions at this time are being held virtually rather than face to face. So that we can keep you informed can you please provide an email address. (Please note that to join in with our virtual sessions, you will need to complete a separate form and agree to the safeguarding consents on our Virtual Application Form.)

Relationship to child*

Are you the Legal Parent/Guardian of the child?*

If you have selected NO and are NOT the Legal Parent/Guardian of the child you are registering, please arrange for the Legal Parent/Guardian of the child to complete a form as soon as possible. This will help us to continue to deliver the service we offer. Thank you.

I agree to ask the Legal Parent/Guardian of the child to complete a form

Details of your Child(ren)

Name of Child*

FIRST name of child SURNAME of child

Child's Date of Birth

Gender of child*

Female
Male

Does your child have any medical conditions? (Disability/Special needs)

Yes
No

If YES, please give brief details

All information will be held securely and used to help you and your child within sessions. We can also help you both to access local services if needed.

I wish to add another child's details*

Yes
No

Information on your other child(ren)

Name of child

First Surname

Child's Date of Birth

Gender of child

Female
Male

Does your child have any medical conditions? (Disability/Special needs)

Yes
No

If YES, please give brief details

All information will be held securely and used to help you and your child within sessions. We can also help you both to access local services if needed.

If you are bringing more than two children to a session, please complete a new form with their details.

Note: If another adult is likely to attend with your children, they will also need to complete their own registration form and re-enter your child's details. (This will enable us to ensure your child's details are correct and not duplicated.)

Emergency Contacts (Optional)

I am aware that this information is optional and not necessary for me to attend sessions or events. I confirm that I have received permission from the person named to: a) Give you their information b) For the details to be stored on Daniel's Den database as per their Privacy Policy c) For Daniel's Den to contact them in an emergency

Emergency Contact Name

Please find below details of someone that Daniel's Den can contact on my behalf in case of an emergency.

Emergency contact - Their relationship to you

(Spouse/Partner/Mother/Sister/Friend)

Emergency contact - Tel No

Emergency Contact - Other Tel No

Can you please tell us...

How did you find out about Daniel's Den?

Consents

1. Photo Consent*

I give permission for photos to be taken and use for publicity of Daniel's Den and as a record of their activities. This may include publication on social media - Facebook; Twitter and the website. (Please note that no photographs or film footage will be submitted for publication without your permisison in accordance with the data protection law and Daniel's Den data protection policy.)

Yes
No

2. Friends of Daniel's Den*

The primary purpose of the 'Friends of Daniel's Den' is to fundraise. Would you like to be kept updated wtih what Daniel's Den is up to and join us in different activities? If so, please say yes to becoming a Friend of Daniel's Den. We will then keep your information and update you with what Daniel's Den is doing next.

Yes - I want to be a 'Friend of Daniel's Den'
No - I do not want to become a 'friend.'

Consent*

* Daniel's Den only maintain your details to help us understand who is using Daniel's Den and plan services within Daniel's Den. You have the right to request a copy of all personal information about you held by us. You also have the right to request any errors be corrected. If any information that you have provided to us changes, please let a member of the Daniel's Den team know.
* I understand the information on this form will be stored on a secure database that is only accessible by authorised staff who have a controlled login.
* I consent to the sharing of information between staff and the partners we work with (i.e. Hosts of venues we are based in.) Please note - Information will also be shared with third parties if there is a legal requirement to do so or if there is a risk of serious harm or threat to life.
* I understand I can withdraw my consent at any time.
* For more information, please view our Privacy Policy which can be found on our website: www.danielsden.org.uk

I hereby confirm that Daniel's Den can hold and store my information in accordance with their Data Protection and Privacy Policies.

Digital Signature (Please type your full name)*

Required to confirm you have given your permission for us to store your details.

Date registration completed

Next steps...

Once you have submitted your registration form, you will be taken to a confirmation page which lets you know that your Registration Form has been sent to us. You will then be shown details of where you can find our Virtual Sessions Application Form. This will need to be completed before you can join in our digital sessions. Once you have completed the Application Form, we will be in touch with you soon via email to provide details of how you can join in with our digital sessions. Remember, there is no obligation to join in with the digital sessions, instead we will keep you informed as to when our in-person sessions will re-open. More information can be found on our website and we look forward to seeing you soon.