Consent Form Summer 0-11 years 2018
Parent/Carer Consent Form for Sunday Groups
This form will be kept on the Church Suite application for All Saints Peckham in accordance with our data protection policy and guidance.
Parent's First Name *
Please add one Parent/Carer/Guardian's Name and then you can add any additional names in additional info
Your answer
Parent's Last Name
Your answer
Child's First Name *
Your answer
Middle Name
Your answer
Surname *
Your answer
Known as
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Address *
Please email us if this changes.
Your answer
Parents/Carers Landline
Your answer
Parents/Carers Mobile *
Please leave the number with the leader of your group on the day if this changes.
Your answer
Parents/Carers Email *
Please email us if this changes.
Your answer
School
Your answer
School Year *
Sex
Photo/Video consent for internal use eg Sunday Services *
Photo/Video consent for external use eg Website *
Please describe any medical first aid needs eg. Asthma using an inhaler *
Your answer
Medical Short
This information will appear on registers.
Your answer
Doctor's details
Name and Number please.
Your answer
Special Needs
Your answer
Additional info *
Please include an emergency contact(Name and Telephone)
Your answer
Submit
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