Backpackers Holiday Bible Club
19th - 23rd August, 10:30 - 12:15 each day, Crescent Church, Belfast

Open to all children entering P1-P7 in September 2019. Numbers are limited.

Any difficulties in completing this form contact reception@crescentchurch.org or tel: 02890244026

Name of Child
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Date of Birth
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Address
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Emergency Contact (including tel no:)
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GP Name and Tel Number
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Special requirements, including medication and allergies
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I give permission for my child's photo to be taken for internal use only
I hereby give permission for (insert name of child) to take part in the Holiday Bible Club at the Crescent Church and my consent for medical treatment and first aid arising out of illness or accidents
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Signed (Parent or Guardian)
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Date
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We do not want your child to miss this opportunity, if you require transportation in order to attend this club, please tick here
By signing this form you are consenting to Crescent Church holding and processing your personal data for the following purposes. Please tick all boxes that apply
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I consent to the Crescent Church contacting me by *
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Signed
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Date
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