Penguin Club Information - CCAA | Charity Supporting Children With JIA

We are looking forward to welcoming your little one to our Penguin Club. To help us make it an enjoyable and fun experience for them, it would be great to know a little more about their habits, likes and dislikes and whether they have any dietary or medical requirements we need to be aware of.

THIS FORM IS APPLICABLE FOR ANY CHILD AGED 5 OR BELOW.

If you have more than one child aged 5 or below, please complete this form for each child as it is important that we have the information separately.

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Full Name of Parent / Guardian*

First Last

Emergency Mobile Number*

Childs Full Name*

First Last

Age of Child*

Please put the age your child will be when they attend the weekend.

Medical Information*

Dietary Requirements*

Helpful information for staff about your child*

Please note down any information you think would be helpful for us to be able to meet your child’s needs while being looked after in Penguin Club. (E.g. Routine – sleep/naps, interests, dislikes etc)

GDPR Check*

I accept the terms and conditions as to how my data will be used