Waltham Forest Children & Family Centre Registration Form Welcome (PLEASE COMPLETE IN BLOCK CAPITALS) Please complete this form and your details will be passed on to your local Children and Family Centre. A member of their team may contact you by telephone to introduce you to the current activities for your family. About You Parent/Carer 1 e.g. Parent/Carer 2 e.g. mother/father father/mother/grandparent/aunt etc. First Name (As on birth certificate) Last Name (As on birth/marriage certificate) Date of birth Relationship to child Address Postcode Home telephone number Mobile telephone number Email address (please write clearly in – block capitals) Do you have a disability If yes please specify Are you a lone parent? Are you employed/self-employed? What benefits do you receive? If you are pregnant when is your baby due? What is your first Language? Do you need an Interpreter? What country were you born in? Please describe your religion Please turn over to complete this form
Waltham Forest Children & Family Centre Registration Form Welcome (PLEASE COMPLETE IN BLOCK CAPITALS) Please complete this form and your details will be passed on to your local Children and Family Centre. A member of their team may contact you by telephone to introduce you to the current activities for your family. About You Parent/Carer 1 e.g. Parent/Carer 2 e.g. mother/father father/mother/grandparent/aunt etc. First Name (As on birth certificate) Last Name (As on birth/marriage certificate) Date of birth Relationship to child Address Postcode Home telephone number Mobile telephone number Email address – (please write clearly in block capitals) Do you have a disability If yes please specify Are you a lone parent? Are you employed/self-employed? What benefits do you receive? If you are pregnant when is your baby due? What is your first Language? Do you need an Interpreter? What country were you born in? Please describe your religion Please turn over to complete this form
CFC-Registration-Form.docx