Deep Sea Divers - Registration Form
Registration form for Christ Church Derby's autumn half term holiday club. The Holiday Club is for 4 - 11 year olds, and will run each day from 8:45am until 12:30pm. (Dates - 30th, 31st October and 1st November).

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Email *
Phone Number (Emergency contact number) *
Full Name of Parent or Guardian *
Parent or Guardian (Please tick appropriate box) *
Required
Children's First Name (s) *
Please indicate the ages of your children *
Please provide your current address *
Allergy or Medical Information - Any intolerances or allergies or Medical conditions we should be aware of? Please provide detailed information below. If no allergies or medical conditions please write Not Applicable.
 *
Please indicate the days your Child or Children will be attending? *
Required
I confirm that I am the parent/guardian of all the above children. I agree that Christ Church Derby can contact me on the supplied email above in order to administer the Holiday Club
 *
Required
I agree to photos and video being taken during the holiday club to be shown during the sessions and used afterwards for promoting future holiday clubs. *
Required
By submitting this form, you consent to the collection and processing of your personal data and that of your child as described in our data privacy Policy. We will use this information solely for the purpose stated and will not share it with third parties. The purpose stated is for registration and communication regarding the Christ Church Derby Holiday club. Additionally, we would like to retain this data for the purpose of keeping in touch with you concerning follow up events at Christ Church that may be of interest. Your data and that of your child will not be kept for any longer than necessary for the stated purpose. You have the right to access, correct, or delete your data or that of your child at any time by contacting us. For more information on how we protect your data, please contact us matt@christchurchderby.org and we will be happy to share our policy. *
Required
A copy of your responses will be emailed to the address you provided.
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