Join the Club at Air NationClub Events / By Paul Slatter Wednesdays in October, November and December at Air Nation Soft Play in Kings Heath Fit for All Club Registration and Air Nation BookingPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Young Person's Name *FirstLastWhich Air Nation sessions are you interested in?Weds 8 Oct 6.15 - 8pmWeds 15 Oct 6.15 - 8pmWeds 29 Oct 6.15 - 8pmWeds 12 Nov 6.15 - 8pmWeds 26 Nov 6.15 - 8pmWeds 10 Dec 6.15 - 8pmEach session costs £2.50 per child/young person. All children/young people must be accompanied by an adult with parental responsibility for them.Date of Birth *These sessions are for children and young people aged 5-16 only.SEND support and What We Need to Do to Make You Welcome *THESE SESSIONS ARE FOR SEND KIDS ONLY and their siblings and friends (see below). Please tell us a bit about SEND support you get at school or relevant diagnoses. Do we need to make any adjustments to this service to make you feel welcome?Tick those that apply: *Autism (ASC)Moderate Learning Difficulty (MLD)Severe Learning Difficulty (SLD)Profound and Multiple Learning Difficulty (PMLD)Social, Emotional and Mental Health Needs (SEMH)Speech, Language & Communication NeedsHearing DisabilityVisual DisabilityMulti-sensory DisabilityPhysical DisabilityOtherGender *Prefer not to sayFemaleMaleOtherWe collect data on gender so that we can show funders the range of young people who comeEthnicity *Prefer not to sayWhite BritishPakistani or Pakistani BritishBlack Caribbean or Black BritishBlack African or Black BritishIndian or Indian BritishBangladeshi or Bangladeshi BritishArab or Arab BritishOther (see below)You can use the box below to describe your ethnicity in your own words.Other Ethnicity : We collect data on ethnicity so that we can show funders the range of young people who comeHome Postcode *We collect data on where people live so that we can show funders the range of young people who comeName of School (or 'Home Educated' or 'Not in School') *We collect data on schools so that we can show funders the range of young people who come and so that we can identify schools to work with in future.Parent/Carer Name *Contact Mobile Number *Contact E-Mail AddressWould you like to add a second Parent/Carer?YesNo add Date you Additional Parent/Carer Name *Additional contact Mobile Number *Additional contact E-Mail AddressSiblings and Friends012You can bring up to 2 siblings or friends - but we will need their names and a contact for their parent/carers so we can make sure they are happy for them to come.Sibling or Friend 1 Name *FirstLastDate of Birth 1 *Parent/Carer Name 1You can leave this blank if you are their parent/carer tooMobile Number or Email Contact 1We will need to contact them to check their consentSibling or Friend 2 Name *FirstLastDate of Birth 2 *Parent/Carer Name 2You can leave this blank if you are their parent/carer tooMobile Number or Email Contact 2We will need to contact them to check their consentConsentI am the person with parental responsbility named above and I give my consent for my child to become a member of the Fit for All Club; for my child's personal data to be used and stored by Childrens Quarter and DENS of Equality and organisations working with them to run the Fit for All Club and provide opportunities to young people who are members of the club; and for Fit for All Club to contact me about this and future opportunities. I understand that I can cancel this membership and withdraw this consent at any time; that I will be given a copy of the data held by the Fit for All Club that relates to my child; and that this data will be stored securely and processed and used responsibly.Submit
