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Bible Club Registration
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2019-05-28T18:59:01+00:00
Registration Now Open!
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Child's Full Name
*
Date of Birth
*
School Class
*
Address
*
Postcode
*
Home Phone
*
Mobile
*
Email
*
What church do you attend (if any)?
Contact person (If parent unavailable)
*
Relationship to child
*
Home Phone
*
Mobile
*
Child's Doctor
*
Doctor's Telephone
*
Special Needs/Important Information
I will inform the leaders of any important changes to my child’s health, medication or needs, and of any changes to the addresses and phone numbers listed above.
*
Yes
No
In the event of illness or accident, having personal responsibility for the above named child, I give permission for first aid to be administered where considered necessary by a trained first aider, if available, or medical treatment to be administered by a suitably qualified medical practitioner. If I cannot be contacted and my child should require emergency hospital treatment, I authorize an adult leader to sign on my behalf any written form of consent required by the hospital. However, I understand that every effort will be made to contact me as soon as possible.
*
Yes
No
During the Holiday Bible Club photographs may be taken for general church purposes & the daily video recap. On signing this form we will assume you have given permission for your child’s photograph to be taken.
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Yes
No
If your child will walk/cycle to and from the club, and you wish them to be able to enter/leave without being signed in/out by an adult, please check the box. (We will also need verbal confirmation of this and will contact you by phone to verify your consent)
*
Yes
No
Name of Parent/Guardian printed in full.
*
I confirm that I have read the above and all details are correct to the best of my knowledge.
*
Yes
Date
*
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