Online Registration and Consent Form

Child's Name:  
D.O.B:
School:   

Address:
Postcode:  Phone:

Email:

Emergency contact name:
Phone (if different):

GP's name:
GP's number:
Any known allergies or conditions:
 

Do we have your permission to take photos of your child during the club and to use these for church presentations and publicity?          Yes          No

I confirm that the above details are complete and correct to the best of my knowledge. In the unlikely event of illness or accident, I give permission for any appropriate first aid to be given by the nominated first-aider. In an emergency, and if I cannot be contacted, I am willing for my child to be given hospital treatment, including anaesthetic if necessary. I understand that every effort will be made to contact me as soon as possible.