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FAMILY DETAILS

Family Registration Form.

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FAMILY DETAILS

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  1. Family Registration Form Under the terms of our policies and the Data Protection Act your personal details will not be disclosed to any third party. Where we ask for details of ethnic origin or date of birth this is to assist us in submitting applications for funding where overall numbers or percentages are required. Withholding any details will not affect your application. Please Note: Registration with Mohawk is only open to families affected by special needs. Although we do not require evidence of diagnosis, the Special Needs box below MUST be filled in. FAMILY DETAILS Please sign ___________________________ Date:___________________ For office use only: Registration Number ____________ Date entered on database __________ Reg. Fee Y N THE WOODLAND CENTRE TRUST, Highfield Lane, Crazies Hill, Wargrave, Berks. RG10 8PU. Tel: 01189 404045 Registered Charity No. 278681 www.campmohawk.org.uk info@campmohawk.org.uk

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