Secret Agents - Holiday Club Registration
Secret Agents is an activity packed holiday club with all the usual mix of fun activities, drama and learning about Jesus from the bible.

The group for children currently in school Year Groups 4 to 6 is at full capacity. We are exploring options to open up more spaces. Unfortunately, we cannot guarantee a space for any child signing up now but if you do sign up you will be added to a waiting list.
Child's first name *
Your answer
Child's surname *
Your answer
Date of birth (please note your child must be primary school age to attend) *
Your answer
School (as of July 2019) *
Your answer
Child's address *
Your answer
School year group as of July 2019 (please note your child must be primary school age to attend) *
Which days will your child be attending?
Tuesday *
Wednesday *
Thursday *
Friday *
Information and Authorisation
Does your child have any illness/disability which the leaders should be aware of?
Your answer
Is your child taking any medication that the leaders should be aware of?
Your answer
Does your child have any allergies or special dietary requirements?
Your answer
My child can make his/her own way home at the end of the session *
In the unlikely event of illness or accident, I give permission for any necessary medical treatment to be given by the nominated First Aider. In an emergency, and if I am not contactable, I am willing for my son/daughter to receive hospital treatment, including an anaesthetic. I understand every effort will be made to contact me as soon as possible. *
Photographs/Electronic Images
I give permission for my child to be photographed when taking part in Holiday Club Activities. (Please note that photo's will be used for display in our church building only and will *not* be posted on any websites or used in outside publicity. If you are concerned about this, please contact us). *
Information and consent
We will not share your information with third parties without your consent unless the law requires us to do so.
For further information about how your information is used, how we maintain the security of your information and your rights to access information we hold on you please contact
You have the right at any time to withdraw your consent for us to use of your information, but this will not affect the lawfulness of our use of your information based on your consent before its withdrawal
I give permission for the child's details to be held on the church's Holiday Club database. *
Your information
Email address *
Your answer
Your first name *
Your answer
Your surname *
Your answer
Relationship to child *
Your answer
Emergency contact number *
Your answer
Second emergency contact number *
Your answer
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