Please fill in the details below:

Parent / Sponsor’s Name (required)

Address (required)

Relationship to child (required)

How will you support your daughter during the So Lady programme? (required)

What expectations do you have for your daughter whilst she is on this programme? (required)

Do you have any holidays booked, if so what are the dates? (required)

Please fill in the details of your daughter/ward below:

Child's Full Name (required)

Address (If different)

Postcode

Name of cell leader:

Name of LCC church:

Any dietary requirements:

Please indicate if your daughter/ward suffers from any of the following:DiabetesEpilepsyEczemaAsthma

Please write details below, along with any other illness that your child suffers from:

Is your daughter/ward currently taking any medication? naYesNo

Does your child suffer from any food allergies, and if so to what?

Emergency contact details:

1st contact

Name (required)

Address (required)

Mobile (required)

2nd contact

Name (required)

Address (required)

Mobile (required)


I understand that:
• This programme is for a duration of 9 months for students in Year 7 & 8
• I will inform KT Children Dept should my child/ward’s health requirements change.
• Every effort will be made to participate in all the programmes.
• I have read the information leaflet and am aware of commitment required.
• Photographs taken of my child while on this programme may be used in publicity materials.
• If my daughter missed more than 2 mandatory events, she will not be able to graduate.
• So Lady Mentorship Programme has limited spaces.

We will use this for our So Lady Mentorship Programme. It won’t be be passed onto a third party. We are GDPR compliant.