Childs Details First Name Last Name Date of Birth School Attending: --- Please Choose --- Alder Coppice Primary School Amblecote Primary School Ashwood Park Primary School Beacon Hill Academy Beechwood Church of England Primary School Belle Vue Primary School Bishop Milner Catholic College Blanford Mere Primary School Blowers Green Primary School Bramford Primary School (Academy) Brierley Hill Primary School Brockmoor Primary School Bromley Hills Primary School Brook Primary School Caslon Primary Community School Christ Church Primary School Church of the Ascension C.E. Colley Lane Primary School Cotwall End Primary School Cradley CE Primary School Crestwood Park Primary School Crestwood School Dawley Brook Primary School Dingle Community Primary School Dudley Wood Primary School Fairhaven Primary School Foxyards Primary School Gig Mill Primary School Glynne Primary School Greenfield Primary School Halesowen C of E Primary School Ham Dingle Primary Academy Hawbush Primary School Hob Green Primary School Howley Grange Primary School Huntingtree Primary Hurst Green Primary School Hurst Hill Primary School Jesson's CE Primary School Kates Hill Primary School Kingswinford Academy Lapal Primary School Leasowes High School Lutley Primary School Maidensbridge Primary School Manor Way Primary Academy Milking Bank Primary School Mount Pleasant Primary School Netherbrook Primary School Netherton C of E School Newfield Park Primary School Northfield Road Primary School Oldswinford C.E. Primary School Old Swinford Hospital Olive Hill Primary School Our Lady & St Kenelm Primary School Pedmore CE Primary School Pedmore High School Pegasus Academy Pens Meadow School Peters Hill Primary School Priory Primary School Quarry Bank Primary School Queen Victoria Primary School Red Hall Primary School Redhill School Ridgewood High School Roberts Primary School Rufford Primary School Russells Hall Primary School Sledmere Primary School St Chad's Catholic Primary School St James Academy St James CofE Primary School St Joseph's Catholic Primary School St Josephs RC (Stour') Primary School St Margaret's at Hasbury C.E. (V.C.) Primary School St Mark's C of E Primary School St Mary's C E (VC) Primary School St Mary's RC Primary School Straits Primary School Summerhill Secondary School Sycamore Short Stay School Tenterfields Primary Academy The Brier School The Bromley-Pensnett Primary School The Dormston School The Earls High School The Ellowes Hall Sports College The Halesbury School The Link Academy The Old Park School The Ridge Primary School The Rosewood School The Rowan School The Sutton School The Woodsetton School The Wordsley School Thorns Collegiate Academy Thorns Primary School Wallbrook Primary Academy Windsor High School and Sixth Form Withymoor Primary School Wollescote Primary School Woodside Primary School Wrens Nest Primary School Out of Borough School No School Address Details First line of Address Second line of Address Town Postcode Childs Equality Information Gender --- Please Choose --- Male Female Non-Binary Ethnicity --- Please Choose --- 01 - White English/Welsh/Scottish/Northern Irish/British 02 - White Irish 03 - Gypsy or Irish Traveller 04 - Any Other White Background 05 - White & Black Caribbean 06 - White & Black African 07 - White & Asian 08 - Any Other Mixed / Multiple Ethnic Background 09 - Indian 10 - Pakistani 11 - Bangladeshi 12 - Chinese 13 - Any Other Asian Background 14 - African 15 - Caribbean 16 - Any Other Black / African / Caribbean Background 17 - Arab 18 - Any Other Ethnic Group 97 - Prefer not to say 98 - Not specified / Not Known 99 - Other Does this child have any Additional Needs/Disabilities/Medical Conditions? --- Please Choose --- Yes No Please provide all details, about any Additional Needs/Disabilities/Medical Conditions? Does this child have any Dietary/Food Allergies? --- Please Choose --- Yes No Please provide all details, about any Dietary/Food Allergies? Have Dudley Council agreed for this child to receive free school meals because you are on a low income? --- Please Choose --- Yes No If "No" to receiving eligible Free School Meals, has a provider referred you? --- Please Choose --- Yes No Has a provider agreed to HAF? --- Please Choose --- Yes No What activities would your child love to attend? --- Please Choose --- Sports Arts & Crafts Drama Days Out Cooking Dance Music Outdoor Activities Other Parent/Gaurdian Details Parent/Guardian First Name Parent/Guardian Last Name Parent/Guardian Email Parent/Gaurdian Telephone Number We process data in accordance with General Data Protection Regulation (GDPR) 2018 and the Data Protection Act 2018. Information will be stored and processed securely on our database system. All data will be held locally or on UK/EU data centres. A full copy our Data Policy and how your data is stored and used can be found at:HAF Privacy Statement I agree to the privacy policy. Please enable JavaScript for this form to work.