Name of Parent/Guardian

Address / tel no/ email

Name of child


Date of birth

Food allergies/ dietary requirements

Additional Information- please tell us anything you think we may need to know

I consent / do not consent for the use of publicity photographs which may be shared on St. James website and facebook page (not to be shared on any other form of social media)

I consent/do not consent for my details to be stored electronically.  Details would not be shared with any third party and only used in case of the need of emergency contact or to share relevant information and advise of forthcoming events.

Signed                                                                                                          Date