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Sign up for the next KICK programme in Tallaght or Clondalkin
All other areas
Register your interest to participate in a KICK programme for all other areas. This information will be used to demonstrate a need in your area.
Date of Birth
Your Email Address
School Name (if applicable)
13. How did you hear about the programme?
word of mouth
Why do you want to do the KICK programme? (can click multiple boxes)
get fit and improve my physical health
improve my mental health
make new friends
learn a new skill
KICK was recommended to me by an organisation/service If yes.....what organisation/service?
Anything else you would like to tell us?
By signing up you agree to your photo/video to be taken for the purpose and promotion of the KICK programme. Photo's /video's may be posted on SDCP/ KICK Ireland social media platforms and website. This information will be stored on our data base and only used in the event of an emergency situation. By signing up, you agree that KICK, may collect, use and disclose your personal data as provided in this form, or (if applicable) as obtained by our organisation as a result of your participation, for the following purposes in accordance with the Data Protection Acts, and our data protection policy: a. The administration of your participation with KICK. Please contact us for further details on our data protection policy, including how you may access and correct your personal data or withdraw consent to the collection use or disclosure of your personal data.