MK Christmas Day Party for the Elderly

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Christmas Day Party 2023
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ELIGIBILITY : THE PARTY IS ARRANGED STRICTLY FOR ELDERLY COMMUNITY MEMBERS WHO WOULD OTHERWISE BE ALONE ON CHRISTMAS DAY

GUEST BOOKING FORM

Title:

Mrs

Miss

Other

Guest's First Name

Guest's Surname:

Age:

Gender:

Male

Female

Address line 1

Address line 2

Address line 3

Postcode:

Contact number:

Attended party before?

Yes

PHYSICAL ASSISTANCE: Check all that apply:

Uses a walking frame

Uses a walking stick

Has to sit in the front of a car only

Uses a Wheelchair

Able to transfer out of the wheelchair into a car

Medical issues that we need to know about e.g. requires medication during the event? Please give details.

Requires having special food? Please give details.

Are there any known allergic reactions to any particular foods? Please give details. ***

Date

I agree to MKCDPE processing my personal data for the purpose of this event.

I agree that any photographs of me taken during the event may be used by MKCDPE for promotional purposes.

*** If preferred, please contact Ruth or Rebecca Seabrook to discuss the personal requirements.
(All medical information is discreetly provided to the guest, as authorised)

Registered Charity Number: 1176046

Many thanks to all the volunteers and helpers. MK Christmas Day Party Cookies

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