Connor Takes The Castle 2018
This is the registration form for our residential, Diocesan weekend from Friday 7th September to Sunday 9th September. The cost is £50, if you book before Saturday 30th June & £60 following this. Payment can be brought to the weekend. The weekend will be in Castlewellan Castle, with sessions, activities, great food and lots of fun.
Further details of the weekend are available on connor.anglican.org.
Name *
Your answer
Young Person or Leader *
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
Gender *
Parent/Guardian Name
Your answer
Parent/Guardian Contact Number
Your answer
Email of Parent/Guardian
Your answer
For Leaders: Emergency Contact (Name and Phone Number)
Your answer
Parish *
Your answer
Group Leader Name:
Your answer
Are you attending the whole weekend or only part? (Please contact Christina for exact costing) *
Does applicant experience any medical difficulties or need any medication?
Your answer
Please specify any dietary restrictions
Your answer
Parent/Guardian must complete the follow questions for young people applying.
Tick to give consent: I do permit my young person to take part in outdoor activities
Tick to give consent: I do permit my young persons' picture to be taken where it may appear on Engage Connor Youth or Diocese of Connor publicity including the website or social media - no names will be attached
I understand that I will have to pay £50/£60 upon arrival or to the parish group leader in advance *
Required
I confirm that I give my consent for my young person to attend the Diocesan Youth Weekend in Castlewellan from 7-9th September. I give permission for basic first aid to be administered and in the event of he/she being taken ill or injured during the period of the Diocesan Youth Weekend so that surgical operation or serum injection becomes necessary, I hereby authorise the leader in charge to sign on my behalf any written forms of consent required, provided that the delay necessitated to obtain my signature might endanger his/her health or safety. I agree that all information above is correct and accurate. I write my name here to give permission:
Your answer
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