Name of parent/carer who will be attending the session

Phone number

Email Address*

Name and ages of children who will be attending the session

Do you or your children have any disabilities or medical needs (including allergies) that we need to know about? Do you or your children have any disabilities or medical needs (including allergies) that we need to know about? Yes No

If 'yes' please give details

During sessions Charlotte regularly takes photos of children and adults engaging in different activities. These may be used for marketing and publicity purposes (e.g. on flyers, Facebook and on her website). Do you give consent for photos to be taken of you and your child for these purposes? During sessions Charlotte regularly takes photos of children and adults engaging in different activities. These may be used for marketing and publicity purposes (e.g. on flyers, Facebook and on her website). Do you give consent for photos to be taken of you and your child for these purposes? Yes No

*We may contact you via email to let you know about future events and activities that might be of interest at Charlotte’s Wood. We won’t pass your email address or any other details on to anyone else. Do you give consent for us to contact you in the future? *We may contact you via email to let you know about future events and activities that might be of interest at Charlotte’s Wood. We won’t pass your email address or any other details on to anyone else. Do you give consent for us to contact you in the future? Yes No