Child's name
*
First Name
Last Name
Sex
*
Date of Birth
*
Primary Year
*
P1
P2
P3
P4
P5
P6
P7
Home Address
*
Parent/guardian Name
*
Parent/guardian Email Address
*
Parent/guardian Telephone Number during event
*
Name of GP, Surgery and Telephone Number
*
Parental Consent - I give permission for my child as named above to take part in the normal activities of the club I understand that while involved in the activities of the club, he/she will be under the control/care of the group leader and/or other adults approved by the church leadership and that while the staff in charge of the group will take reasonable care of the children, they cannot necessarily be held responsible for any loss, damage or injury suffered by my child during, or as a result of the activities.
*
In an emergency and/or I cannot be contacted, I am willing for my child to be receive necessary hospital or dental treatment including an anaesthetic.
*
Please give details of any regular medication, medical conditions (eg asthma, epilepsy, diabetes), additional needs or disability that may affect this activity.
There will be a snack provided during the event. Please advise of any allergies or dietary needs.
I am happy for John Knox Church to retain the contact details above and to contact me or my child about future events for families or children at John Knox church
*
At John Knox Church we are committed to ensuring church activities follow good practice. Please let us know whether you are happy for us to take photographs and video of your child during the event for the following purposes
*
Thank you for registering!
We look forward to welcoming you on the 16th.
If you need any more information please email kids@johnknox.org.uk
