I give permission for this child to appear in any photos or videos taken during this Holiday Club:*


Your relationship to this child:*



Legal guardian:


Please state:

Your email address:*

In the unlikely event of illness or accident I give permission for any necessary treatment to be administered by first aiders:*


Child's GP phone no:*

Yes Please

No Thanks

Number of adults attending party

Number of children attending party

Any other information it might

be helpful for us to have:

Please enter 'I Agree' as

confirmation for this application:*


*Required information

Will you be attending the party on Thursday night, 6-7.30pm?

(These will only be used to publicise Holiday Club. None of the children will be identified)


For safety reasons we are unable to accept children under 5 years old (except those that will turn 5 during August 2018)

Holiday Club Registration Form 2018

Holiday Club is for children who will be going in to years 1-7 in September 2018.

Register each child using this form, onechild per form please.

Registering gives your permission for the child to attend Holiday Club 2018.

***Your contact details will only be used for Church purposes and will not be shared with any 3rd party