Nature Buddies Family Registration Form 2025

PLEASE COMPLETE ONE FORM PER FAMILY

Family Name / Surname (required)This field is required

Name (s) of all adults (16 plus) who may attend (required)This field is required

Name (s) of all children (under 16) who may attend and age (required)This field is required

Home Address (required)This field is required

Postcode (required)This field is required

Main Contact Name and Number (required)This field is required

Email Address (required)This field is required

Ethnicity: (required)This field is required

How did you hear about Nature Buddies? (required)This field is required

Are there any medical conditions/allergies/dietary requirements/additional needs that we need to be aware of? (required)This field is required

I agree that as Parent/Guardian/Carer, I must remain at the allotment in a supervisory role for the child/children in my care for the duration of the session (required)Please tick a checkbox

Yes

Do you agree to photos/videos of yourselves being taken at the sessions, which may appear on Social Media, publications, displays, newsletters etc (required)Please tick a checkbox

YesNo

Marketing - We would like to send you news, event information and newsletters concerning The Dorothy Parkes Centre. Your data will only be stored for marketing purposes and not shared with 3rd parties. If you no longer wish to receive direct marketing, please email [email protected].

Way of receiving information: (required)Please tick a checkbox

EmailPhonePostText/WhatsApp

Type of information: (required)Please tick a checkbox

NewsEvent InformationNewsletter

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Last name (required) Please enter your last name

Email (required) Please enter your email address Please enter a valid email address (e.g. [email protected])

Find us

Dorothy Parkes Centre
Church Road, Smethwick
West Midlands B67 6EH

+44 (0)121 558 2998
[email protected]

Open:

9am - 8.30pm Monday - Friday

9am - 1pm Saturday/Sunday

Charity no. 1093189

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