Registration Form - Lewisham Children & Family Centre

LCFC Registration Form

Step 1 of 5 - Family Address

Please fill out this form to register with Lewisham Children and Family Centres. Fields with a red * are required to be filled in.
Today's Date*

Day
Month
Year
Family Address*
Number and Street Address Line 2 Town Post Code
Housing Details*
Choose from list

Parent/Carer 1*
First Name Last Name
Phone
Email
Relationship to Child*
How would you describe your gender?*
Date of Birth*

Day
Month
Year
Ethnicity
Disability/Additional Need: Please select
Religion: Please select
Are you in employment? please select
Are you registered with a GP? Please select
Are you pregnant? please select*
If Yes what is the due date
MM slash DD slash YYYY
Are you a lone parent? please select
What language is spoken at home?

Here at Lewisham Children and Family Centres we take your privacy very seriously with your consent we will process, retain and store your personal data on behalf of the London Borough of Lewisham in line with the General Data Protection Regulation (GDPR) (EU) 2016/679.
Your data is stored on a secure database controlled by the London Borough of Lewisham for the purposes of monitoring, evaluation and for the provision of Lewisham Children and Young People’s Partnership services, without consent no service can be provided.
Your personal data and contact details will not be shared with any other third party or organisation but may be shared with other Children and Family Centres, and other partnership organisations.
You have the following rights regarding your personal data:
• The right to withdraw consent at any time
• The right to request your personal data is deleted
• The right to access to your personal data

For more information regarding the use of your personal data please see www.lewishamcfc.org.uk or make a request to:
Lewisham.Secure@pre-school.org.uk or
Pre-school Learning Alliance, Camelot Centre, 50 Meliot Road, London, SE6 1RY and a copy of the policy will be sent to you.
Consent*
- I understand that by providing my consent I am confirming I understand how and why my personal data is used and give permission for Lewisham Children and Family Centres to store and update my personal details.
Consent*
- I am a parent/legal guardian of a child/children under the age 16 and give consent for Lewisham and Children Family Centres to store and use my child/children’s personal data for the purposes of the service.
Contact
I give permission to Lewisham Children and Family Centres and any relevant partner organisation to contact me regarding services available and my access to them by the following:
- Telephone (including text messages)
- Email
- Post
Signature - Please type in your name*
Email
This field is for validation purposes and should be left unchanged.

First Name	Last Name	NHS Number	Date of Birth	Male/Female	Ethnicity	Current Nursery/School	Registered with a Dentist Yes/No	Disability (please state)

Welcome to the Early Years Alliance Lewisham Services Website

LCFC Registration Form

Step 1 of 5 - Family Address

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