Please fill out the following form to register your family with the Maple Tree. Please enable JavaScript in your browser to complete this form.About you Name *Include first name, last name and preferred title.AddressInclude house number/name, street, and village/town/city.PostcodeContacting you Email *Phone number *About your child/children Relationship to child/children* **If you do not have parental responsibility for the child or children you are bringing to the centre, please ask the child’s parent to also complete and sign the consent information.About your child/children *Please give name(s) and date(s) of birth and tell us if there is anything we should know to help support you and your children such as home language, special needs and disabilities, food allergies. About other adults Any other person who may attend sessions with your children (such as partner, grandparent, other carer)Include first names, last names and preferred titlesAddress (if different to yours)Include house number/name, street, and village/town/city.Email (if different to yours)Phone number (if different to yours)Additional information You do not have to complete the following information to register with us. However, doing so will help us to provide the best support for you and your children. We may also use this information anonymously to help us apply for funding and grants. If your home language is not English, please tell us what it isDo you and/or your children have any food allergies? If so what are these? Do you and/or your children have any needs that might require adjustments to our service (such as disabled access, large print, quiet spaces)Any other information that might help us support you and your familyMaternity careHelp with housingChildcareBenefitsRefugee statusAny particular requirements linked to your beliefs or culture (please state)Other (please state)Further informationAdd further details on conversations you would like to have with us about the support we offer.EthnicityWhite BritishWhite otherAsian or Asian BritishBlack, Black British, Caribbean or AfricanMixed or multiple ethnic groupsOther ethnic groupPrefer not to sayEthnicityPlease add further information on your ethnicity if you would like.Privacy *I consent to the Maple Tree holding the above personal details about my family for the purpose of funding and providing activities that meet the needs of my family.I would like to receive:details of the Maple Tree programmequarterly newsletterdetails of events and projectsSignature *Date *Submit
