Rising Stars - Expression of Interest Form

Thank you for your interest in Rising Stars.

Rising Stars is a SEND-friendly stay and play service for children aged 0–5 with additional needs.

Venue: Myatt's Field North Community Centre
Start date: Thursday 3 September
Time: 10:30am–12:00pm
Frequency: Every Thursday during term time

Completing this form does not commit you to attending — it simply helps us understand

demand and plan sessions.

Parent / Carer Details

Parent / Carer First Name:

Parent / Carer Last Name

Email address:

Phone Number:

Child Details

Child's first name:

Child's age:

Does your child have additional needs or are they awaiting assessment/diagnosis?

YesAwaiting assessment Not sure / exploring support

Additional Information

Is there anything you’d like us to know about your child to help us plan sessions?

Data Protection: By ticking 'Yes', I consent to KEEN London securely storing my own and my child's personal data, including my name and contact details, in its CRM systems, for the purpose of contacting me about future sessions, events, news, and other relevant updates. My contact information will be deleted six years after I leave KEEN London unless I subscribe to the relevant Alumni mailing list.

Your privacy is very important to us, and you can withdraw your consent at any time by emailing info@keenlondon.org

Do you agree?

YesNo

Contact Information