Children's Club 2021 Registration Form
Upney Baptist Church - Midweek Children's Club 2021/22

When: Every Wednesday during school term.

Explorers: School year reception to year 5 - 6.30pm - 8pm

Impact: School year 6 to year 11 - 6.30pm - 8pm

If you would like to register your child to attend, please complete and submit the form below.
*For multiple children please submit one form per child.*

We look forward to seeing you there!
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Child's First Name *
Child's Last Name *
Child's Date of Birth *
School year of your child *
Home Address (including postcode) *
Church Attended (if applicable)
Name of GP Surgery (in case of emergency) *
GP's telephone number *
Known medical conditions (e.g. asthma, allergies) *
(Emergency Contact) Name *
(Emergency Contact) Relationship to child *
(Emergency Contact) Telephone number *
(Emergency Contact) Mobile *
Please list any questions you may have in the box below
Email address for responding to questions (if an email address is not provided we will phone you with a response to your questions using one of the emergency contact numbers provided).
Do you give consent for your child to have their photo taken and/or to be included in a video clip? *
Under Data Protection legislation the church Charity Trustees of Upney Baptist Church are the Data Controller and can be contacted by emailing . We are collecting this information to enable the church to run the Club safely and ensure we can contact you (or other nominated adult) in case of an emergency. Data Protection legislation allows us to process this information as we regard it as being in the church’s legitimate interest. If you are unable to supply the information requested then we will be unable to accept your child at our Club. The information you supply will be held in paper form in a securely locked cupboard in the church office. Only the Minister, the church children’s club leaders, and administrator will have access to this information. The forms will be destroyed once the Club has finished unless you have ticked the box below asking us to keep you informed about future activities we think your child might be interested in attending. If this is the case, we will retain your details for the sole purpose of notifying you of such events. If we retain your details, they will be stored electronically. We will NOT pass on this information to anyone else. You have the right to ask to be removed from the circulation list at any time.If you are concerned about the way your information is being handled please speak to our Data Protection Trustee. If you are still unhappy you have the right to complain to the Information Commissioners Office. *
I confirm that the details included in this form are complete and correct to the best of my knowledge.In the unlikely event of illness or accident I give permission for any necessary 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 hospital treatment. I understand that every effort will be made to contact me a soon as possible. (TYPE NAME AND ADD DATE BELOW - e.g. John Smith 10/07/2021) *
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