Nurture in Nature Questionnaire

Your name *

First

Last

Your email address *

Your telephone number *

Your address *

How many children are attending with you? *

One Child
Two Children

Please note that all children attending including babes in arms need to be booked onto the class.

Child 1's Name *

First

Last

Child 1's Age *

Child 2's Name *

First

Last

Child 2's Age *

Do you, or any of your children who will be attending have any accessibility needs, or any allergies or medical conditions we should be aware of?

What are you preferred pronouns for yourself and your family?

What motivated you to join the Nurture in Nature classes?

Can you tell us a little about your child/children who will be attending the session?

This may include likes/dislikes, details of your child's personality or any additional needs.

Are you familiar with mindfulness techniques and do you use them regularly?

Is there anything else you'd like to share with us?

By completing and submitting this questionnaire you are giving permission for The Milk Hub & Parenting Explorers to collect and process the above information including any personal information as defined under GDPR regulations, and in line with both our legitimate interests. All information you supply is held in the strictest confidence and not shared with other third parties without your consent. The only exception is where we have a legitimate safeguarding concern for the wellbeing of you and/or your children, when we are duty bound to pass on information to the relevant agencies. Completing and submitting this questionnaire also acknowledges that you accept the Privacy Notice and Terms and Conditions listed on the website The Milk Hub. *

I agree

By completing and submitting this questionnaire you agree to be responsible and supervise your child/children at all times throughout the Nurture in Nature sessions. *

I agree

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