Mega Makers Holiday Club!
Rylands Community Church Holiday club: August 12th - 16th 2019
Email address *
Child's Surname *
Your answer
Child's First Name *
Your answer
Child's gender *
Child's date of birth *
MM
/
DD
/
YYYY
School year you child completes in July 2019 *
Your answer
If your child would particularly like to be in a group with friends (in their age group), please give their names below and will we try to accommodate this where possible.
Your answer
Address *
Your answer
Parent / Guardian's name *
Your answer
Emergency contact phone numbers *
Your answer
Please state below any medical, physical or emotional concerns that we should be aware of in order to properly care for your child. This could include illness, allergies, medication, disabilities, phobias, dietary requirements, family issues, relationship difficulties or anything else
Your answer
Would you like to discuss your child's additional needs before holiday club starts?
If yes, please provide a contact number or email address and someone will be in touch
Your answer
Where did you hear about this holiday club? *
Your answer
Do regularly attend church? If so, please state where *
Your answer
Statement
All children must be dropped and collected from the church by an adult. Please ensure that your child is ticked on the register before leaving the group. We are a Christian youth group and have a Christian ethos. Christian teaching will be included in the activities. For more information please visit our website: www.rylands.org. Data contained on this and other forms will be securely stored, including on electronic devices, by Rylands Community Church staff or volunteers during your child’s registration with the group. We will use this data for the purposes of administering the Holiday Club. We may use this data to contact you for related purposes, such as letting you know about future Holiday Clubs or other events that may be of interest. We are committed to safeguarding all those in our our care and operate a safeguarding policy. We have qualified first-aiders present. If your child should ever need emergency attention, please give consent for our first-aiders to undertake emergency treatment to a level of their first-aid training. Should further emergency treatment be necessary appropriate NHS services will be used. Occasionally we may take photographs or video footage of the activities and children. These photographs or video may be electronically stored by our staff or volunteers and reproduced only in presentations for the purposes of Rylands Community Church.
I have read the above statement and agree with all terms and conditions therein. I consent for my child to attend the Summer Holiday Club run by Rylands Community Church. *
Your name and relationship to child *
Your answer
Information
Rylands Community Church is a congregation of Beeston Free Church, which is a registered charity. Reg No 116 0335
Submit
Never submit passwords through Google Forms.
This form was created inside of Beeston Free Church. Report Abuse - Terms of Service