Childs Name *

First Name

Last Name

Childs Name 2

First Name

Last Name

Child Name 3

First Name

Last Name

Child Name 4

First Name

Last Name

Checkbox *

I give permission for my son / daughter to take part. I understand that leaders will take all reasonable care during holiday club, but I acknowledge the possibility that my child, for a short time, may be out of sight of a leader during the holiday club time. I understand that personal accident insurance is my responsibility. I give permission for emergency medical treatment to be carried out in the event that I cannot be contacted.

Checkbox

I am happy for my details to be kept on a church database, to be informed of other events

Checkbox

I give permission for photographs / video to be taken of my children or internal use only