April Regional HubPlease fill out the form below to register your interest for this FREE event: Name * First Name Last Name Email * Phone number * Number of guests in the party * Please advise how many children/young people and how many adults Do you have any dietary requirements? Choose your pizza slice Margarita Pepperoni Is there anything else we need to know? Region you are attending from? * Bromley / Bexleyheath / Dartford / Gravesham /Sevenoaks Medway / Swale Tonbridge & Malling / Tunbridge Wells / Maidstone Ashford / Shepway Canterbury / Dover / Thanet I would like a phone call to discuss my child's specific need as adjustments may be needed for us to access the event. * Yes, I would like a phone call No, I do not neet a phone call Data and Media Permissions - Please read carefully and check boxes * I agree that 21 Together has full rights to use the images resulting from the photography/video filming (submitted by yourselves or filmed by others), and any reproductions or adaptations of the images for such uses including (but not limited to) staff training, advertising, social media and grant applications to help achieve the 21 Together aims. They are likely to be used online, and will be published on social media platforms where we will be unable to fully monitor their use. I agree that 21 Together may collect and store the data included in this form for the purposes of its completion. I do not agree to 21 Together taking photography of my child/young person. PLEASE RAISE THIS WITH 21 STAFF AT THE START OF EACH SESSION. Thank you!