a gray - wiltshire children and families voluntary sector …€¦ · · 2017-03-30reet salisbury...

Wiltshire Children’s Centre’s

This letter is intended for professionals and our partners only Dear Colleagues,

Welcome to your quarterly Wiltshire Children’s Centre Pack that will provide you with all you need to know to refer children and families for our services. This may be as simple as engaging parents into our groups or providing one to one outreach support via a Family Support Worker. Please see our attached timetable for details of groups and services.

Families may access any Centre that is most convenient to them and you can refer for specific programmes and outreach services via the relevant contact details above. This pack contains our registration and referral forms. Please circulate the timetable where possible and please let us know if you would like any hard copies sent out to you.

Making a referral: All families with children 0-5 years can be referred for any centre service, as below, using the attached referral form: • Family Support Outreach Work (one to one support at home)-providing the details of why the support is needed (e.g. CP/CIN plan, CAF, parenting support, finance/debts, housing etc.) • Parenting-one to one in the home • Finance, debt, housing support • Referral to specific programmes as detailed on our timetable (page 2) • Signposting to a host of partner agencies • Support applying for ‘Better2Gether Funding’ (two year old funding) • Support to access universal groups such as ‘Little Learners’. • And much more!

Yours Faithfully A Gray Children’s Services Manager

West Wiltshire Children’s Centre Westfield Road,

Trowbridge BA14 9JQ

01225 719753

[email protected]

South Wiltshire Children’s Centre 24 St Edmunds Church Street

Salisbury SP1 1EF

01722 323208

East Wiltshire Children’s Centre Southbroom Road,

The Green, Devizes,

SN10 5AA 01380 739835

Wiltshire

Children’s Centres

Information

Welcome to the Wiltshire Children’s Centres

South- central contact line: 01722 323208 Little Folly, Salisbury City, Bulford, Tisbury and Mere

East- central contact line: 01380 739835

Tidworth, Pewsey, Devizes

West- central contact line: 01225 719753 Studley Green, Longfield, Canberra, White Horse

Spurgeons, a national children’s charity, became the lead and employing body for the children’s centres in

April 2016, following a tender process by Wiltshire Council.

All centres run a full programme of universal and targeted services including centre based sessions and outreach work in the community. These include:

• Little Learners

A group aimed at parents with 0-3’s however children up to 5 years are welcome. Sessions will provide learning opportunities for children through positive play. All sessions are underpinned by the Five to Thrive ethos and include regular information around attachment, healthy lifestyles, careers advice, and staying safe.

• Baby Massage A five week targeted programme aimed at families with the greatest need. (by written referral only). For parents and their non-moving babies to encourage bonding and communication through soothing touch.

• Mum2Mum Breastfeeding Group For all breastfeeding Mums (or Mums to be!) and their babies to gain support from trained peer supporters and to socialise with other new mums.

• First Aid Demonstration 60 minute demonstration for parents/carers covering choking, drowning and meningitis. (By written referral only)

• Incredible Years Parenting Programme: A 12 Week course for parents/carers focusing on positive strategies to promote children’s social and emotional confidence. (By written referral only) Crèche facilities may be available if booked in advance. (By referral only)

• Hey! Healthy Eating for Young Children: A 7 Week Course for parents/carers and their 2-5 year olds including healthy eating and shopping on a budget. Completion of the course can lead to a Level 1 award in Health Improvement. (By written referral only)

• You and Me, Mum: A 10 week course for parents/carers providing information and strategies on understanding the effects of domestic abuse on women as mothers and on young children, effective communication skills and protective behaviours for keeping mothers, children and young people safe.

• Baby Steps: Perinatal course for parents to be- (by written referral only).

• Health Visitor Drop-In Clinics

• Health Visitor led Weaning Sessions, Developmental Checks and Midwife Postnatal appointments (By appointment only)

• We work with partners to also deliver-Family Learning (Maths/English/ESOL/Time 4 U), Splitz (Making Changes), Learning Curve (Fabulous Families and Parents with Prospects), Wiltshire IAPT (Well-Being After Baby, Stress Management)

• Wiltshire Employment Advisor (Troubled Families Programme)-One to One appointments and short courses (By referral only)

ALL of our sessions are provided free of charge. Please contact the individual centre for more details.

Family Support

There are times when parents, children and carers need additional help. Children’s centres work in

partnership with parents and carers and can provide individual family support.

This can include assistance and support with:

• Parenting • Employment and Training • Bereavement • Family Separation • Special Needs or Disability • Housing • Debt • Benefits • Safety • Depression • Domestic Abuse • Mental Health, Drug or alcohol issues

A Family Support and Outreach Worker could:

• Talk to children and their parents/carers within a group situation • Meet children and their parents/carers individually at home or at the children’s centre • Help parents/carers find the support they need.

If you would like to speak to a Family Support and Outreach Worker you can contact your local children’s centre. External agencies can make referrals to the children’s centre, if there is a child under 5, where it is felt that a family would benefit from the support we can offer. Referrals must be signed by the parent.

Adult Learning

The children’s centres work in partnership with Family Learning and Learn Direct and host various courses. These include:

• Adult Literacy • Adult Numeracy • Employability • ESOL (English for Speakers of Other Languages) • Finance • Healthy Eating

Parents/carers can book onto these courses, although places are limited. Please contact the individual centre for further information.

Working with Schools Each of the children’s centres are based within a reach area. In these areas are a number of settings including child minders, pre-schools, nurseries, parents and tots groups, and schools. The children’s centres work in partnerships with these settings to support school readiness, transition, and applications to settings. Although children’s centres mainly work with children under 5 - we play an important role in supporting school readiness. By identifying development needs within our reach areas we are able to target our services appropriately and offer outreach to feeder settings, to support children’s development-linking in to the overall aim to raise attainment in the EYFS across South Wiltshire.

We are developing our links with feeder settings and schools in each reach area.

Volunteer Opportunities

Spurgeons has depended on Volunteers for 145 years to help deliver services which change the lives of children and families. We value our volunteers as individuals, and as part of the teams within each children’s centre. There are lots of opportunities for all levels of experience:

• Volunteer Welcome administrator: To support the Admin Team, Centre Manager and Team colleagues ensuring a high level of confidentiality is maintained

• Volunteer Parent Representative: To support families in sharing their views and feedback regarding the services offered with in our children’s centres in order to adapt what is needed.

• Volunteer Early Years Worker: To support Early Years Workers in delivering a range of play opportunities (indoors and outdoors), for families with children under 5 years old.

• Gardening: Some of the Salisbury Children’s centres have gardens and help is always appreciated with their upkeep.

You can develop your interests or start something new; build your confidence or put something back into the community. If you are interested in becoming a volunteer at one of the children’s centres please ask to speak to the Volunteer-Co-ordinator in your area by phoning the relevant central line.

Timetables and Contact Details

Each centre runs a programme of sessions throughout the year (some groups are term-time). All of the children’s centres have Facebook pages that parents/carers can ‘like’ to receive updates about events and timetables. Contact details for the children’s centres can be found on the timetable. There is a single point of contact for the children’s centres as per the numbers below. Parents/carers can do this by going into any of the centres and completing a registration form, and then they can access any of the services and use all of the Spurgeons children’s centres in Wiltshire. Should you need to refer a family to one of the children’s centres to benefit from the support that we may be able to offer, please use the attached referral form or contact us on the relevant central line:

• South Wiltshire: 01722 323208 • East Wiltshire: 01380 739835 • West Wiltshire: 01225 719753

Spurgeon’s Children’s Centre’s cover the whole of South, East and West Wiltshire

The Rise Trust has centres in North Wiltshire.

We hope you find this pack helpful.

Please use the attached referral form if you would like to access services.

Health Visitor Drop-In Clinic

On this page only regular drop-in events –no need to pre-book. Just turn up!

Monday Tuesday Thursday Friday

Little Learners 0-5 years

Downton Baptist Church 9.30-11.00 (weekly)

Wilton Community Centre 10.00-11.30 (weekly)

Wednesday

South Wiltshire Children’s Centres Programme April - June 2017


Bulford Children’s Centre 10.00-11.30 (weekly)

Mum2Mum Breastfeeding Groups

Wilton Community Centre 10.00-11.30

Mere Children’s Centre 10.00-11.30

Downton Baptist Church 11.00-12.30

Little Folly Children’s Centre 1.00-2.30


Old Sarum Community Centre

10.00-11.30 (term time only) Mere Children’s Centre

1.00-2.30 (term time only)

For info and queries contact: South Wiltshire Children's Centres 24 St Edmunds Church Street, Salisbury, SP1 1EF 01722 323208


Salisbury Methodist Church

1.00-2.30 (weekly) Mere Children’s Centre

9.00-11.00(weekly)


Little Folly Children’s Centre 1.00-2.30 (weekly)

Little Learners Info

Sessions will provide learning opportunities for children through positive play All sessions regularly include: • Healthy Eating • Careers Advice • Staying Safe

Mum2Mum Breastfeeding Group

Salisbury Methodist Church 1.00-2.30

Bulford Children’s Centre 9.30-12.00 (weekly)

Little Folly Children’s Centre 9.30-11.00 (weekly)

Wilton Community Centre (Not 1st Thurs of the month)

10.30-11.45


Tisbury Children’s Centre 9.30-11.00 (weekly)

Redworth Centre, Amesbury 10.00-11.30 (term time only)

Friary Community Centre 10.00-11.30 (term time only)


Tisbury Children’s Centre 11.00-12:30


Old Sarum Community Centre

(2nd and 4th Tues of the month)

1:00-2.30

Search for ‘South Wiltshire Children’s Centres’

Childminders Group Little Folly Children’s Centre

9:30 – 11:30 (term time only)

Bulford Children’s Centre 9:30 – 11:30

(term time only)

Wellbeing Clinic Nadder Centre

(1st and 3rd Tues of the month) 10:00-12.00


Bulford Children’s Centre 10.00-11.30

https://www.facebook.com/

Advisory Board Meeting

Be part of shaping your children’s centre service.

All parents welcome. 10th May @ Little Folly

Children’s Centre

Wiltshire Health Trainer

Baby Steps A peri-natal programme for

expectant parents @ Little Folly Children’s Centre

By referral only

Venue Details:

Little Folly Children’s Centre, 73a Pinewood Way, SP2 9HX

Bulford Children’s Centre,

Hubert Hamilton Road, SP4 9JY

Mere Children’s Centre Springfield Rd, Mere, BA12 6EW

Tisbury Children’s Centre

Weaveland Road, Tisbury, SP3 6HJ

Downton Baptist Church Hall, South Lane, SP5 3NA

Friary Community Centre,

112 Carmelite Way, SP1 2HW

The Redworth Centre, Antrobus Road, Amesbury, SP4 7ND

Old Sarum Community Centre,

Partridge Way, SP4 6PX

Salisbury Methodist Church, St Edmonds Church Street, SP1 1EF

Amesbury Baptist Church,

Butterfield Drive, Amesbury, SP4 7SN

Wilton Community Centre West Street, Wilton, SP2 0DG

Healthy Eating for Families!

Find out all about healthy eating & how important it is

for your child! Fun, relaxed sessions

including: • Shopping on a budget • Preparing Foods • Gain a Level 1

qualification Complementary Childcare

Available Starting 3rd May @ Salisbury

City Children’s Centre

Infant First Aid Would you know what to do in an emergency?

Book onto a First Aid Safety Information Session

Family Support Service

One to One support when you need it most for a range of

issues that can affect family life (parenting, debt, mental health

issues, housing etc). Appointments can be either in

your own home or at the centre.

Call us for a confidential chat.

Ask us about free childcare sessions for your

2 year old!

On this page you will find details of our specialised programs available. Please ring 01722 323208 for further information or to express your interest in the courses shown below. All our services are FREE.

(Please note that some courses require a referral from a health professional)

Infant Massage

5 week course for parents with young babies

(Referrals from a health

professional will be required)

@ Little Folly Children’s Centre

Back to Work (Wiltshire Employment

Advisor) Develop skills to help get back

into employment. Learn in a relaxed and

informal setting Complementary Childcare

Available Starting 28th April @

Amesbury Baptist Church

5th May @ Mere Children’s Centre

Bookstart A 5 week course for families to

engage and build their confidence around stories,

books and rhymes. @ Little Folly 18th May

One to One Sessions Friendly support to improve

your health and make positive lifestyle

changes Call for us an appointment

You & Me Mum A 10 week course covering:

• The effects of domestic abuse on women as mothers and on children & young people •Effective communication skills with children & young people •Healthy and non-violent relationships •Protective behaviours and strategies for keeping mothers, children & young people safe

Starting 2nd May Call the central line for more

information

Collect your Healthy Start Vitamins from any of our

Children’s Centres. Ask a staff member

for details

http://www.wiltshire.gov.uk/schoolseducationandlearning/earlyyearsandchildcare/earlyyearschildcareprofessionals/freenurseryentitlement/twoyearoldfunding.htm?cookieid=124306&cookiedlg=reject&action=setoutside

Child Health Clinic Paxcroft Community Centre

12.30-2.30



Little Learners Forest Community Centre, Melksham.

10:00 - 11:30 Term Time Only

Wednesday

West Wiltshire Children’s Centres Programme April - June 2017

Little Learners Bellefield Primary School

(Old Children’s Centre) 10:00 - 11:30

Term Time only

Child Health Clinic Studley Green Children’s

Centre 1.30-3.30

Little Learners Info

Sessions will provide learning opportunities for children through positive play All sessions regularly include: • Healthy Eating • Careers Advice • Staying Safe


Studley Green Children’s Centre ,Trowbridge

10:30 - 12:00

Little Learners Leigh Park Community

Centre- Westbury. 9:30- 11:00

Term Time only

Collect your Healthy Start Vitamins from

any of our Children’s Centres. Ask a staff member

for details

Search for ‘West Wiltshire Children’s Centres’

Child Health Clinic Canberra Children’s

Centre 9:15-11:30

Longfield Children’s Centre

10:00-12:00 Bradford-On-Avon Library

12:30- 2:30

Mum2Mum Breastfeeding Group White Horse Children’s Centre 10:15 -11:45

For info and queries contact: Studley Green Children's Centre Westfield Road, Trowbridge BA14 9JQ (01225 719753)

Mum2Mum Breastfeeding Group Canberra Children’s Centre 10.30-12.00 The Baptist Church, Warminster 1:30-3:00

Child Health Clinic White Horse Children’s

Centre 9.30-11.00

Canberra Children’s Centre, Melksham

12:00-1:00

Sensory Room Available to book for 30 minute slots at Children

Centres in West Wiltshire


Advisory Board Meeting

Be part of shaping your children’s centre service.

All parents welcome. Time & date TBC

Baby Steps A perinatal programme

covering the weeks just before & after having your baby. At

Longfield Children’s Centre On Wednesday &

Westbury Children’s Centre on a Thursday

By referral only

Venue Details:

White Horse Children’s Centre Eden Vale Road, Westbury BA13 3NY

Canberra Children’s Centre

56 Spa Road, Melksham SN12 7NY

Longfield Children’s Centre Broadcloth Lane, Trowbridge BA14 7HE

Studley Green Children’s Centre

Westfield Road, Trowbridge BA14 9JQ

Paxcroft Community Centre 17 Hackett Place, Hilperton,

Trowbridge, BA14 7GW

Bradford-on-Avon Library Bridge Street, Bradford Upon Avon

BA15 1BY

Leigh Park Community Centre Leigh Park Way, Westbury BA13 3FN

Bellefield Primary School

Windermere Road, Trowbridge BA14 8TE

Forest Community Centre Bowmans Court, Melksham

SN12 7FF

The Baptist Church, North Row, Warminster,BA12 9AD

Healthy Eating for Families!

Canberra Children’s Centre Starts Wednesday 26th April from 09:30-12:00 (6 weeks) Find out all about healthy eating & how important it

is for your child! Fun, relaxed sessions

including: • Shopping on a budget • Preparing Foods • Gain a Level 1

qualification Complementary Childcare

Available



One to One support when you need it most for a range of

issues that can affect family life (parenting, debt, mental health issues, housing etc).

Appointments can be either in your own home or at the

centre. Call us for a confidential

chat.

Ask us about free childcare sessions for your

2 year old!



Back to Work (Wiltshire Employment

Advisor) Develop skills to help get back

into employment. Learn in a relaxed and

informal setting Complementary Childcare

Available At White Horse Children’s

Centre Starts Monday 8Th May

9.30am-11.30am (6 weeks)

Call 01225 719753 to register for our 2 hour First Aid course at Studley Green

Children’s Centre. Friday 16th June 9:30 –

11:30.

Wiltshire Health Trainer

One to One Sessions Friendly support to improve

your health and make positive lifestyle changes .

You & Me Mum A 10 week course covering:

• The effects of domestic abuse on women as mothers and on children & young people •Effective communication skills with children & young people •Healthy and non-violent relationships •Protective behaviours and strategies for keeping mothers, children & young people safe

Date and venue tbc

Incredible Years Parenting

A course focusing on positive parenting strategies.

At Longfield Children’s Centre Starts on Tuesday

25th April from 1:30 – 3.00 12 weeks)

Complimentary Childcare available


https://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjVqOOci6jOAhUEOhQKHZwPDqcQjRwIBw&url=https://www.blackpoolbetterstart.org.uk/news/baby-steps/&psig=AFQjCNGtjZN_e6toSicuJza0opZ3Q0GW8g&ust=1470411320314957

Child Health Clinic Devizes Children’s Centre

1.00-2.30



Marlborough Library Drop In

Children Centre staff will be available for any

questions or support you may need.

9.00am -12.00pm

Wednesday

East Wiltshire Children’s Centres Programme April - June 2017

Little Learners 10.00-11.30am

St James, Victoria Rd, Devizes. Term Time Only

Learn & play sessions for 0-3’s

Child Health Clinic Windmill Hill Children’s

Centre 9.30-11.45

Little Learners 10,00 -11.30am

Marlborough Scout Hut SN8 4BX

Term Time Only Sessions will provide learning opportunities for children through positive play All sessions regularly include: • Healthy Eating • Careers Advice • Staying Safe


Devizes Children’s Centre 10:00 – 11:30

Collect your Healthy Start Vitamins from

any of our Children’s Centres. Ask a staff member

for details

Search for ‘East Wiltshire Children’s Centres’

Mum2Mum Breastfeeding Group Marlborough Library 10:00-11.30

Mum2Mum Breastfeeding Group Windmill Hill Children’s Centre 10.00-11.30

Watch out for our Easter Bear Hunt Dates coming soon

Sensory Room Available to book for 30 minute slots at Pewsey

and Windmill Hill Children’ Centres

Child Health Clinic Marlborough Library

1.00-2.30

Castle Practice, Ludgershall

(1st & 3rd Monday of the month) 1.00-2.30pm

Child Health Clinic Pewsey Children’s Centre

1.30-3.00pm (1st and 3rd Wednesday of the

month

Health Trainer One to One sessions Friendly support to

improve your health & make positive lifestyle

changes Call for an appointment

Sensory Room Available to book for 30 minute slots at Devizes

Children’ Centres


https://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiZ3tv207fSAhWMWBQKHZH4ByYQjRwIBw&url=https://www.pinterest.com/moniiku89/we-bare-bears/&psig=AFQjCNHNPYjWOCZsXnyQcViL4tQX718w9A&ust=1488536873341938

Baby Steps

A perinatal programme For expectant parents . At Windmill Hill Children’s

Centre On Wednesday By referral only

Venue Details:

Devizes Children’s Centre Southbroom Infants School,

The Green, Devizes SN10 5AA Tel: 01380 739835

Windmill Hill Children’s Centre

Wylye Road, Tidworth SP9 7QR

Pewsey Children’s Centre Wilcot Road, Pewsey SN9 5EW

Marlborough Library 91 High Street,

Marlborough SN8 1H

Devizes Children’s Centre Starts Thursday 27th April

from 09:30-12:00 (7 weeks) Find out all about healthy

eating & how important it is for your child!

Gain a Level 1 qualification Complementary Childcare

Available



One to One support when you need it most for a range

of issues that can affect family life (parenting, debt,

mental health issues, housing etc).

Appointments can be either in your own home or at the

centre. Call us for a confidential

chat.

Ask us about free childcare sessions for your 2 year old!



Infant Massage

5 week course for parents with young babies

(Referrals from a health

professional will be required) @ Windmill Hill Children’s

Centre

Get Set for Work (Develop skills to help get

back into employment. Learn in a relaxed and

informal setting At Devizes Children’s Centre

Starts 22nd June 9.30am-11.30am (4 weeks)

Call 01380 739835to register for our 2 hour First

Aid course at Devizes Children’s Centre and

Windmill Hill Children’s Centre.

Incredible Years Parenting

A course focusing on positive parenting strategies. Windmill Children’s Centre Starts on Friday 28th April

from 9:30 – 11.30 12 weeks At Marlborough Scout Hut

Starts on Monday 24th April from 10:00 – 12.00pm 12

weeks) Complimentary Childcare

available

Moving On with English

With Wiltshire Family Learning

FREE 19 week English course to work towards

a qualification. Crèche spaces available

Starts Tuesday 25th April,

9.30-11.30 am at: Pewsey Children’s

Centre. Call to book a space

Freedom Starts April 2017 at

Devizes Children’s Centre

A 10 week programme for mothers who experience or have experienced domestic

abuse. It aims to empower you, build

confidence and learn to recognise the signs of abuse,

Please call for dates and

to book your space. Complementary Childcare

available


https://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjVqOOci6jOAhUEOhQKHZwPDqcQjRwIBw&url=https://www.blackpoolbetterstart.org.uk/news/baby-steps/&psig=AFQjCNGtjZN_e6toSicuJza0opZ3Q0GW8g&ust=1470411320314957

Name of Parent/Main Carer:

Date of Birth: Ethnic Group:

Address: Home Telephone Number:

Mobile Number:

Do you have any disability/Special Needs? (Please tick)

Yes No

Details: Name of Child:

Date of Birth: Ethnic Group:

ADDRESS: (if different) Does the child have any disability/Special Needs? (Please tick)

Yes No

Details: Family Details: Details of other family members: (Please include second parent/carer and siblings where relevant)

Name Date of Birth Living at above address? (Y/N)

Legal Relationship to the above

Ethnic Group

What languages do you speak/understand?______________________________ Do you need Support with written materials? Y/N Service requested: (Please tick all that apply) 1:1 Family Support Work Adult Education/Back to Work Parenting Healthy Lifestyles advice Infant Massage (Young Parents) Introduction to Services LIFT Other

3. Request for Services Form Spurgeons Wiltshire Children’s Centres

Reason for referral: (This section must be completed in all cases) CAF in place? Y/N Named Lead Professional: Is the family involved with Children and Families-Social Services? (Please give brief description and name of Social Workers) Child In Need: Y/N Child Protection: Y/N

Name of family Health Visitor: Any other relevant professionals/agencies involved: (Please list name, role and contact number) Are there any particular health & safety issues/potential risks which staff need to be aware of? Referrer Details (Please tick): Request from? Self Referral Professional Name:

Job Role (If professional referring):

Contact Address:

Email address:

Contact Number:

We must have signed consent before referral can be actioned. Signatures: Parent/Carer 1: …………………………………………………….. Date……………………… Parent/Carer 2: …………………………………………………….. Date……………………… Has the family agreed to this request and are aware that this information will be kept confidential in accordance with the Data Protection Act 1998

Yes No

The Children’s Centre will keep your information securely in accordance with the Data Protection Act 1998. You may, of course, view this information, please ask the Centre Lead. The Children’s Centre will not normally share your information with other agencies without your consent. However if we have serious concerns that a child/ren or a parent is at risk of serious harm we may have a duty to share your information with other agencies without your consent as part of our duty of care.

Office use only Date request received: Allocated to:

Action:

Please return to: [email protected]

mailto:[email protected]

Other Parent/Carer

Employment Status: (Please select) Full Time Part Time Self Employed Looking after family Training/Education Maternity Leave Sick/Disabled Retired Unemployed Volunteer

Ethnicity: (Please select)

Bangladeshi Indian Pakistani Chinese Any other Asian White & Asian Black‐African Black– Caribbean Any other black background White & Black African White & Black Caribbean Any other mixed background White– British White– Irish Traveller of Irish Heritage Gypsy/Roma Any other white background Any other ethnic group

Do you have a disability or additional needs?

Are you: (Please select) A Home owner Renting (Private) Renting (Social) Living with parents Other Living in a rural community? Yes/No A Lone Parent Yes/No Or your partner in the forces? Yes/No A Teenage Parent? YesNo Living in a workless household? Yes/No Claiming benefits Yes/No If yes, which type? ............................................... Expecting a baby? Yes/No If yes, when is your due date?............................

Title

First Name

Surname

Date of Birth

Address

Postcode

Telephone Number

Mobile Number

Marital Status

Email Address

Country of Birth Relationship to child/ren

To ensure that you and your family are being offered the services you are entitled to,

Spurgeons Children’s Centres need to gather personal information about you and your family.

What will we use the information for? To let you know about services and activities To contact you to find out your views about our

Children’s Centres To get you the support you may need from other

services To monitor and evaluate the services you receive All information is stored securely in line with the Data Protection Act 1998 and will not

be shared without your prior consent.

Wiltshire Children’s Centre’s Registration Form

Main Parent/Carer (Person with parental responsibility)

Title

First Name

Surname

Date of Birth

Address

Postcode

Telephone Number

Mobile Number

Marital Status

Email Address

Country of Birth Relationship to child/ren

Employment Status: (Please select) Full Time Part Time Self Employed Looking after family Training/Education Maternity Leave Sick/Disabled Retired Unemployed Volunteer

Ethnicity: (Please select) Bangladeshi Indian Pakistani Chinese Any other Asian White & Asian Black‐African Black– Caribbean Any other black background White & Black African White & Black Caribbean Any other mixed background White– British White– Irish Traveller of Irish Heritage Gypsy/Roma Any other white background Any other ethnic group

Are you (please select) A Home owner Renting (Private) Renting (Social) Living with parents Other Living in a rural community? Yes/No A Lone Parent Yes/No Or your partner in the forces? Yes/No A Teenage Parent? YesNo Living in a workless household? Yes/No Claiming benefits: Income Support/ Job Seekers Allowance/ Housing Benefit/ Incapacity Benefit Pension Credit/ Severe disability Allowance/ Other Expecting a baby? Yes/No If yes, when is your due date?............................

Do you have a disability or additional needs?

Child 1 Child 2 Child 3

First Name

Surname

Date of Birth

Gender

Ethnicity

Any additional needs, disability or allergies? (Please state)

Children (Under 16) Please continue on a separate page if necessary

Declaration I understand that the information I have provided will be kept on file (including the Children's Centre database), for Children's Centre statistical monitoring and evaluation purposes. This will also be included in a ’family file’ contain‐ing attendance and achievements that I will have access to on request. I understand that the Children's Centre may contact me and will send me information on services and events. Your mobile number will be shared with Teachers 2 Parents in order for us to contact you by text. Any information regarding you and your family is kept confidential and will not be passed to organisations outside of Children's Centre partners without your consent, unless it is of a child protection nature, in which case information will be shared with appropriate agencies. The Children's Centre undertakes to keep all information provided in a secure location. (Please tick here if you do not consent) In completing this form I consent to my photo or image and that of my child/children being used to promote and publicise this Children's Centre in a variety of formats including: newspaper, television, video, posters, internet, leaflets and any other medium which will enable this Children's Centre to promote the work it does. Images will not be used for any other purpose. (Please tick here if you do not consent) I declare that all information I have provided to the Children's Centre is true to my knowledge Parent 1 Signature: …..……………………..…………… Date: …………………….. Parent 2 Signature: …..……………………..…………… Date: ……………………..

For Office Use Only: Data Input by........................................................ Date.................................... Estart Number: SOA:

a gray - wiltshire children and families voluntary sector …€¦ · · 2017-03-30reet salisbury...

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