CKHC Child Registration Form
CKHC is open to primary school aged children, i.e. those just completing a year in Reception to Year 6 (born between 1 September 2006 and 31 August 2013).

To register a child, you will need to have bought a ticket and have the Ticket Number and Registration Code to hand.

You will need to complete a separate registration for each child.

We take confidentiality seriously and will not share any of the information you provide with anyone without your consent.

Email address *
Ticket Number *
This is shown on your ticket
Your answer
Registration Code *
This is shown on your ticket and allows us to verify your purchase
Your answer
Child's Details
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Address *
Your answer
Date of Birth (Day) *
Date of Birth (Month) *
Date of Birth (Year) *
Which school year is your child completing this summer? *
Gender *
Security Keyword *
Please enter a keyword that you and your child know for security purposes (this will need to be used by the person collecting your child at the end of the day).
Your answer
Days Attending *
Required
School *
Which school does your child attend.
Your answer
Church *
Do you or your child attend a church (or Sunday School)? If so please tell us which one. Please answer "None" if appropriate.
Your answer
Medical Details
Doctor's Name or Practice *
Please enter the name or practice of your doctor
Your answer
Doctor's Phone number *
Please enter the phone number for your doctor
Your answer
Medical Condition *
Does your child have a medical condition that we should know about, e.g. allergies, etc.? If so, please enter a brief description. Enter "None" if this does not apply.
Your answer
Medication *
Please indicate below if your child may require medication, particularly whilst on site with us, e.g.:
Required
Medication (cont.)
Please provide any further relevant details regarding any medication that your child may require. You will be asked to bring any medication in a sealed plastic bag clearly marked with your child's name. Further instructions may be given in the parents' letter issued nearer the time.
Your answer
Medication (cont.) *
Please provide us with the date of your child's most recent Tetanus vaccination
Your answer
Special Needs *
Does your child have any special needs, e.g. learning or behavioural difficulties, etc. that we should know about in order to ensure your child is in a comfortable environment and adequately supported? If so, please enter a brief description. Enter "None" if this does not apply.
Your answer
Parent/Guardian Details
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian - phone number *
Your answer
Parent/Guardian Address
if different from the child's address detailed above
Your answer
Parent/Guardian Postcode
if difference from that of the child detailed above
Your answer
Parent/Guardian Helper *
Is the parent or guardian also registering as a helper during the week?
Emergency Contact Details
Please provide the contact details (name and phone number) for 2 people in case of emergency
Emergency Contact 1 (name and phone number) *
Your answer
Emergency Contact 2 (name and phone number) *
Your answer
Data Protection & Consent
We take data protection and confidentiality seriously and will not use any of the information you have provided or share it with anyone without your consent.

Under the new data protection regulations (taking effect from 25 May 2018) we are obliged to obtain your consent to process the data provided for the purposes of the administration of Cookham Kids' Holiday Club. We would also like your consent to retain your contact details for the purposes of contacting you for future CKHC events, e.g. for volunteering next year. Finally we will be taking photographs and possibly some video footage during the week and so need your consent for your children to be included in those photographs and videos.

Please confirm your consent below for us to process the data provided in this registration for the purposes of CKHC 2018 (parental/guardian consent is required for children under 13). *
Required
Please confirm your consent below for us to retain your contact details for the purposes of contacting you in relation to future CKHC events, e.g. attending or volunteering next year. *
Required
We may send out materials relating to Church activities throughout the year; please indicate if you are happy for us to use the information in this registration for this purpose *
Photographs *
Please confirm your consent below for photographs of your child to be taken and used for the purposes of CKHC?
Required
Video Footage *
On Sunday 5 August we will hold a family service in Holy Trinity Church at 11am to celebrate the week and share the activities with friends and family of the children attending and the local community. We may take some video footage during the week, primarily to be used during the Sunday, service but possibly also for other CKHC related purposes, e.g. training sessions for volunteers, but will not be put into the public domain such as the internet. Please confirm your consent below for video footage of your child to be taken and used for the purposes of CKHC, particularly during the Sunday Service at the end of the week (5 August 2018).
Required
Thank you for completing this registration
We hope your child has a fantastic time with us at CKHC.

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