All at Sea Registration form
Child's details
Child's full name *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Sex *
School
Your answer
School year just completed
Address *
Your answer
Postcode *
Your answer
Any medical conditions, allergies, or special needs we should be aware of? *
Your answer
GP Name
Your answer
GP Telephone number
Your answer
Emergency contact details - please provide two contacts
1. Name *
Your answer
Relationship to child *
Your answer
Telephone number *
Your answer
2. Name
Your answer
Relationship to child
Your answer
Telephone number
Your answer
If desired, please give the names of children your child would like to be grouped with at the club.
Your answer
Parent/Carer Consents
In the unlikely event of illness or accident, I give my permission for any necessary medical treatment to be given by the nominated first-aider. In an emergency and if I cannot be contacted, I am willing for my child to receive any treatment a hospital/doctor may consider necessary. I understand that every effort will be made to contact me as soon as possible. *
I consent to my child's photograph being taken at the club. Photos may be displayed in the church or on the church website or used in a newspaper review. Names will not be attached to publicity photographs. *
I understand that my details will be held electronically by Street Baptist Church for a period of up to one year from the end of the club. Street Baptist Church's data protection policy can be read in full here: http://www.streetbaptist.co.uk/wp-content/uploads/2018/05/sbc-data-protection-policy-may-2018.pdf * *
I confirm that the details are complete and correct to the best of my knowledge. *
Name of parent or carer signing for the child *
Your answer
Address if different from the child's
Your answer
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