Sign Up Form - Walsall Council

If you want guidance on how to register to HAF, there's a video available for you to view. You will only need to register once for the HAF Programme, and please ensure you fill in all required fields before continuing.

Please remember your registered email and password, as this will be used to access the HAF services.

Confirm Email

Email must match

Password

At least 8 characters
At least 1 uppercase character
At least 1 lowercase character
At least 1 special character
At least 1 number

First name

Last name

Address Line 1

Address Line 2

Town

County

Postcode

Daytime Phone Number

Mobile Number

Confirm that you are the parent or guardian of the child you are signing up

How many children would you like to register?

Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
Child 8
Child 9
Child 10

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

SEND or Disabilities Does your child have any special educations needs or disabilities (SEND)? If yes, please explain their needs and the requirements needed to ensure they can access HAF provision. Please explain this as best as you can as this will allow the provider to identify the best support for your child whilst on this provision. It is essential for us to have clear, current and up to date information about your child's needs. Failing to disclose all special educational needs and/or disabilities (SEND) including support requirements for a child can lead to complications including being turned away from a provision. We aim to ensure your child has a positive experience and this will prevent any issues on the first day. (Please use this space to tell us about all the support that is required for child)

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Personal Care Needs Does your child have personal care needs? If yes please explain these, including what support they will require in as much detail as possible. i.e., Nappy changing, support with going to the toilet, assistance with feeding?

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child Unique Code (as per letter)

Child First name

Child Last name

Child Preferred Name

Child Date of Birth

School

Spoken Language

Child Ethnicity

Child Collection Do you require someone other than yourself to collect your child from the Holiday Activity Programme?

Yes

I give permission to the following person/s to collect my child from the Holiday Activity Programme in my absence

Name of person/s collecting your child

Security Password

Yes

EHCP Does your child have an Education Health and Care Plan (EHCP)? If so, please upload it. (you can send this directly to the provider)

Yes

Short Breaks Passport Does your child have an up to date short breaks passport? If so, please upload it. (you can send this directly to the provider)

Yes

Please can you explain the behaviour your child may use and how to respond to this behaviour? If applicable.

Medical Needs Does your child have any medical needs? If so, what are they?

Yes

What dietary needs does your child have?

Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
Child 8
Child 9
Child 10

All information provided is used for the purpose of registering you on the HAF programme. This registration will continue each year automatically subject to your entitlement to Free School Meals remaining unchanged. You can withdraw from the programme at anytime please email WR4C@walsall.gov.uk.

Your information may be shared with other organisations in order to enrol you on selected activities but we will only share when there is a lawful basis to do so. For more information on how Walsall Council use your data please see our main privacy notice and data protection pages at Data Protection | Walsall Council.

Once registering your child we will need to share your child’s personal information with ONLY providers who deliver the Activity and Holiday programme and ONLY for the purpose of the delivery of the programme.

We will be using your registration for any future upcoming events for the holiday programme. If you would not like to be contacted about this programme in the future please contact WR4C@walsall.gov.uk

I understand this consent will be used for any upcoming holiday programmes

I understand and agree to you sharing my and my child’s personal information with ONLY providers involved in the delivery of the Activity and Holiday programme and ONLY for the purpose of the delivery of the programme, access to book activities and the completion of occasional surveys to improve the programme.

It is recommended that you consult with your doctor before your child begins any exercise program but particularly if you are aware that they have any underlying medical conditions. These should be declared on the enrolment form. They should be in good physical condition and be able to participate in the advertised activity.

I confirm that my child in my care may take part in any physical activity. Walsall Council cannot be held responsible for any damages to my child or property that may occur as a result of undisclosed personal details.