West Midlands Event
Your Information
Parent/Carer First name
Parent/Carer Surname
Email address
If you are a Reach adult, please check this box
Name of Reach child
Age of Reach child
Names of siblings attending
Ages of Siblings attending
How many adults attending?
Details of any dietary requirements/allergies ( Please list names against allergy/requirement) NB: Please also note if EpiPen is needed for allergies
I give permission for Photos/videos taken at the event to be shared
On the Closed Facebook Page
On the Reach Website
In Within Reach Magazine
All of the above
None of the above
Please write your name here to recognise that you understand that parents are responsible for their children at all times.
Contact Information