Which day/s will your child(ren) be attending? *

Monday
Tuesday
Wednesday
Thursday
Friday

[Parents] First Name *

[Parents] Last Name *

Email *

Contact *

Is your child(ren) eligible for free school meals? *

How many children will be attending? *

Child's Name *

Child's Name (2)

Child's Name (3)

Gender of child *

Gender of child (2)

Gender of child (3)

Date of Birth of Child 1 *

Date of Birth for Child 2

Date of Birth for Child 3

Does your child(ren) require SEND support? *

If yes, please provide details *

Address Line 1 *

Address Line 2

City *

State/Prov/Region *

Postal/Zip *

Country *

Child's Ethnic Origin (please list each childs name if more than one with their ethnic origin) *

Mother's Maiden Name *

Father's Name *

Additional Comments

Add anything else you would like us to know about your child here, for example child is " looked after " by a foster parent

Emergency Contact *

Emergency Contact's Relationship to child *

Emergency Contact Number *

Emergency Contact Address *

Name of Family Doctor *

Doctor's Address *

Doctor's Contact Number *

Any Allergies? *

Additional comments for allergies (please state each child's allergy and confirm child's name if more than one)

Any Medical Conditions? *

Additional comments ( list all medical conditions, if more than one child list each name with their condition)

I agree to the following (select those you are happy for your child/children to be involved in and provided with)

Bandages
Plasters
Sunscreen
Photo's for club or educational use only
Video recording for club or educational use only

Additional comments

I agree to the below Parental Consent Statement *

Yes I agree

I, being the parent/guardian of the child(ren)s names(s) above, hereby give permission for the Manager to give the immediate necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my son's/daughters interest, in the doctors medical opinion, for any delay to be incurred by seeking my personal consent.

Thank you for registering!

We are happy to have you on board! A big welcome to you, {{customer.name}}.

If you are in receipt of Free School Meals and or if your child requires SEND support, please send supporting evidence via email: info@mulacakekidsclub.com

If you are a paying parent, please pay to:

Mula Cake Kids Club CIC

Barclays

Sort Code: 20 90 74

Account Number: 03687538

Or PayPal

paypal.me/MulacakekidsclubCic

Any donations can also be made via:

Fundraiser for Dexter Simms by Mariam Bashua : Help Children Attend and enjoy Christmas Hols 2022 (gofundme.com)

ALL PARENTS

Click the link below:

https://dextersimms.kartra.com/portals/UdJ6Al5mBOCp

And click forgot password

Shortly you will receive your login details to your very own parent portal!

Why don’t you follow us on social media as well?

@mulacakekidsclub on Instagram

@mulacakekids1 on Twitter

and like our page on Facebook @MULACAKEKIDSCLUBCIC

& remember...

Don't leave your child cakeless!

Thank you for registering!

We are happy to have you on board! A big welcome to you, {{customer.name}}.

If you are in receipt of Free School Meals and or if your child requires SEND support, please send supporting evidence via email: info@mulacakekidsclub.com

If you are a paying parent, please pay to:

Mula Cake Kids Club CIC

Barclays

Sort Code: 20 90 74

Account Number: 03687538

Or PayPal

paypal.me/MulacakekidsclubCic

Any donations can also be made via:

Fundraiser for Dexter Simms by Mariam Bashua : Help Children Attend and enjoy Christmas Hols 2022 (gofundme.com)

ALL PARENTS

Click the link below:

https://dextersimms.kartra.com/portals/UdJ6Al5mBOCp

And click forgot password

Shortly you will receive your login details to your very own parent portal!

Why don’t you follow us on social media as well?

@mulacakekidsclub on Instagram

@mulacakekids1 on Twitter

and like our page on Facebook @MULACAKEKIDSCLUBCIC

& remember...

Don't leave your child cakeless!

Mula Cake Kids Club Registration Form

Thank you for registering!

Thank you for registering!

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