CCRYouth Online Registration Form
Thank you for taking the time to fill in our registration form, this enables us to keep young people safe within our activities and helps us to stay in touch with you. This form is held securely on a database for the duration of the young persons attendance at our activities. We recognise that circumstances change, please inform the Youth Team in writing of any changes as soon as possible.
1. Young Persons Full Name
Your answer
2. Young Persons Date of Birth
MM
/
DD
/
YYYY
3. School
Your answer
4. Young Persons Contact Details (mobile number or email used by young person)
Your answer
5. While your child is in our care it would be helpful for us to know whether they suffer from any ALLERGIES, PHOBIAS, MEDICAL CONDITIONS, DISABILITIES or DIETARY REQUIREMENTS
Your answer
6. Please give details of any MEDICATION (please ensure adequate supply is brought to events if it could be needed and ensure the organiser is informed)
Your answer
7. Name, Address & Telephone of Doctor
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Christ Church. Report Abuse - Terms of Service - Additional Terms