Weston and Newbridge Food Club Referral Form

This referral form can be completed by anyone wishing to become a member or can be filled out by a referring organisation (as long as they have prior permission). Anyone who lives in/around Weston and Newbridge and is on a low income, struggling to buy high quality food is welcome to register (we will not require proof of eligibility). 

The Food Club runs on Mondays at Weston Hub from 12noon-2pm. Members can drop in without booking. It is £2 for an individual and £3 for a family a week.
If you need support filling in the form please email us or just turn up on a Monday to register.

Full Name:

Address:
Town:
Postcode:

Telephone:
Mobile:

Email Address:

Number of Adults:
Number of Children:
Any known Allergies:

 
Each time that you visit the Food Club, you need to be certain... 

• That in your selection of food, you have taken into account any allergies of yourself or anyone in your household.  The Food Club does not take any responsibility for this. 
• That you have a working fridge or freezer at home to store the chilled or frozen food safely.

Please tick the box to confirm you have read and agree to the above statement  

If you are referring from an organisation:

Referrer's Name:
Name of Organisation:
Telephone Number:
Email address: