Light Parties 2022 – Register – Bourne Baptist Church

CHILD INFORMATION

Name of Child *

First

Last

Date of Birth *

Which party is the child attending? *

0-4 yr 4:30-5:30
5-11 yr 6:00-8:00

Register Child 2

Add information for a 2nd child

Name of 2nd Child *

First

Last

Date of Birth of 2nd Child *

Which party is the child attending? *

0-4 yr 4:30-5:30
5-11 yr 6:00-8:00

Register Child 3

Add information for a 3rd child

Name of 3rd Child *

First

Last

Date of Birth of 3rd Child *

Which party is the child attending? *

0-4 yr 4:30-5:30
5-11 yr 6:00-8:00

MEDICAL INFORMATION

Please provide details of any medical conditions, disability, allergies, dietary needs and special needs

If registering more than one child please specify which child the information applies to.

PARENT/CARER INFORMATION

Name of Parent/Carer *

First

Last

Contact Number for Parent/Carer *

Email of Parent/Carer *

Email

Confirm Email

CONSENTS

Photos Consent (Local Display or Publicity)

I consent to photos being taken of my child/children for local display or publicity.

Photos Consent (Website)

I consent to un-named photos being used on the church website.

Receive First Aid

In an emergency, if I cannot be contacted, I give permission for my child/children to receive first aid or necessary hospital treatment, including anaesthetic.

PROMOTIONAL MATERIAL

Future Activities

Please keep me informed of any other activities for children and families at Bourne Baptist.

Future Events

I would like my eMail address to be added to the Bourne Baptist Church events mailing list.

DECLARATION (to be completed by a parent/carer with parental responsibility)

Consent *

I confirm that the above details are correct. I give permission for my child to take part in the normal activities of the holiday club. I also agree to immediately inform the group leaders if anything written on this form about the child changes. I understand that information provided for the child/children and for all parent/carers will be stored electronically and in paper format.

Name of Person Completing Form *