Children's Network Application

The Children's Network offers:

Events:

Fun Days with Family & Friends
Parent Carers Information Days

Newsletter:

Fun and entertainment for children and young people
Interesting articles for parents & carers

The 'Find It Guide' with information about:

Suitable leisure opportunities
Telephone Helplines
Relevant Voluntary Organisations
Funding & Welfare Rights
Special transport
Education & transition to adult services
Parent Carer Support Groups
Home Services and Housing

Consultation:

The chance for disabled children, young people, their parents and carers to tell us about their needs.

You can register now:

Just fill in the form below
It's your chance to be included if you wish
You have nothing to lose and your child may have a lot to gain
Children and young people receive a birthday card every year and are asked if they wish to continue membership
If there's anything else you would like to know please contact the Childrens Network Project Officer on 0191-3834095 or see our contact page.

About the Children's Network

The Children's Act says that Social Services must keep a Register of Children with Disabilities.
You decide whether or not to register your child or young person.
The network is for those aged from birth to their 18th birthday.
The Network Forum includes parent / carer representatives.
The Network aims to help you make sense out of the masses of information which is available.

Please note that any information that you provide is subject to the Data Protection Act.

Fields marked with this symbol * must be completed.

* Child's Surname:
* Child's Forename(s):
* Child's Address:
* Postcode:
Email:
Telephone Number:
* Gender:
* Date of birth, e.g. 01/02/1973:
Name of Main Carer:
Relationship to Child:
Address (if different from above):
Postcode:
Telephone Number:
Child's Ethnic Origin:
Child's Religion (if any):
Main Language used in the home:
Is there anyone else who has parental responsibility:
School/Nursery (including address):

Definition of a Child's Disability

"A child with a disability is under the age of 18 and has a substantial impairment which limits or prevents him/her from living and developing as other children of a similar age and social/cultural circumstances. ''

The Children's Network recognises that social and environmental factors can further disadvantage a child with a disability.

Please tick any disabilities which apply:

Physical
Chronic Illness
Learning
Language/communication
Visual
Hearing
Other (please give details):

If your child has a specific condition diagnosed please give details: (eg. Autism, Downs Syndrome):

Data Protection Act

Privacy Statement

I certify that the information which I have given on this form is correct to the best of my knowledge and belief. I understand that it will be processed by computer and used in accordance with the registration made by Durham County Council under the terms of the Data Protection Act 1984.

I understand that statistical information may be disclosed to agencies specified in the registration including, for example, Health Authorities and Medical Practitioners.

I understand that this form is not a request for services and will not prompt a referral to any of the agencies involved.

Do you agree to the above conditions: Yes No