New Baby Form

Home » New Baby Form

Your postcode qualifies for this offer.

Please apply below.

Parent Name *

First

Last

Email *

Baby's name *

Baby's date of birth *//

Address

House or flat number

Second line address

Postcode

Phone

If you have a number you can be contacted on please let us know.

Food Allergies/ or Intolerances

Privacy terms *

I give my consent for Healthy Living Platform to process my data and my baby’s data and share the information with LEAP for the purpose of equalities reporting, service evaluation and reporting anonymous information about the programme to the funder, National Lottery Community Fund. I am aware that further information about Healthy Living Platform, LEAP and how this data is collected, securely stored and reported on is available and I can freely request for this information. I am also aware that I may withdraw my consent at any time by using the LEAP Data Subject Consent Withdrawal Form which may be obtained by request from LEAP.

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