Keswick in Buckie Epic Explorers Holiday Bible Club Registration
Holiday club is for children aged 5-11 (on 6th august 2018). It's free to come along but you will need to register.

TIME: 10am - 12pm
DATE: Monday 6th August - Thursday 9th August 2018
VENUE: Buckie Baptist Church, Cluny Place, BUCKIE AB56 1JN
CONTACT: kibkidsclub@gmail.com

PLEASE COMPLETE MULTIPLE TIMES IF REGISTERING MORE THAN ONE CHILD.

Child's First Name *
Your answer
Child's Surname *
Your answer
Age (at 6th August 2018) *
Gender *
Child's Address *
Your answer
Child's School *
Your answer
Parent(s) / Carer(s) Home Tel Number
Your answer
Parent(s) / Carer(s) Mob Tel Number *
Your answer
Any Additional Contact Number
(who would take parental responsibility, family member or friend)
Your answer
Parent(s) / Carer(s) Email Address
Your answer
GP Name & Tel Number *
Your answer
Health Requirements? (If none, please state NIL) *
Does your son / daughter have any medical condition / allergy or take any medication?
Your answer
Additional Learning Needs?
Your answer
Photos Permission *
PHOTOS WILL BE TAKEN AT THIS EVENT FOR FUTURE PUBLICITY PURPOSES. ARE YOU WILLING FOR US TO INCLUDE YOUR CHILD IN PHOTOS?
Data Storage & Protection *
The government have recently introduced new laws around data protection. We would very much like to keep in touch with you. By completing this form, you consent to Keswick in Buckie processing your personal data, provided by you on this form, for the purposes of including it in our contacts directory (not a public document). We would also like to keep in touch with you to inform you about Keswick in Buckie news, events and activities.
Required
Consent *
I GIVE PERMISSION FOR MY SON / DAUGHTER TO ATTEND KIB EPIC EXPLORERS HOLIDAY CLUB AND TAKE PART IN ALL IT'S ACTIVITIES. In the unlikely event of an emergency, it is important that the person in charge of the group has necessary information about any medical condition / allergy that could affect your son or daughter’s treatment, and to be able to contact a parent / carer or other member of your family / friend. Although we try to ensure that a first aider is available, should any serious injury / illness arise we may need to call the emergency services and therefore need your consent to any emergency medical treatment which may be necessary. Whenever medical advice or treatment is needed, the assistance of a GP or A&E department will be sought. The Children’s Act 1989 allows a doctor to provide any necessary treatment for the purpose of safeguarding and promoting the child’s welfare. I consent to any emergency / surgical treatment which my son/daughter may require during the time with us. I understand every effort will be made to contact me.
Required
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