Illuminate Registration Form

Hello!

It's great to see you, we're very excited that you'd like to join in with Illuminate! Please fill in the details below as accurately as possible to help us get to know you:
Your Child

Please provide as much information as possible:
Full Name of Child*

First NameMiddle NameLast Name
Date of Birth*

DayMonthYear
Child Address*

Street Address

Street Address Line 2

Town/CityCounty

Postcode
School (if applicable)
Any known allergies/medication requirements*
Parent/Guardian

Please tell us about you:
Name of Parent / Guardian*
Relationship to Child*
Telephone (home)
(of parent/guardian)
Mobile*
(of parent/guardian)
Email*

Special permissions
Youth Groups on Zoom

I understand that when it is not possible to run the usual children and youth work, some sessions may take place on the video conferencing platform Zoom. There will always be two adult leaders present in such a group and they will follow the Church Wigan Safeguarding Working Procedures for Zoom Calls. All invitations to such a meeting will be sent to you as the parent or guardian together with the times of the sessions.

Please be aware that each of these online platforms has their own privacy policy/ notice with regards to the data that they are gathering. You should read these yourself & ensure that you review what cookies are active and change these settings to necessary cookies only.
Consent to Attend Online Clubs*

I give permission for my child to take part in Zoom sessions following the above guidelines.
I give permission for photos to be shared of my child on Facebook, Instagram and other social media platforms deemed appropriate (including Church Wigan and St Marks Church websites*

YesNo
Behaviour
Parental Acknowledgement*

I acknowledge the need for appropriate behaviour from my child and understand that I may be contacted if their behaviour is not acceptable.
Data Protection

Your privacy is important to us and we would like to communicate with you about the church and its activities. To do so we need your consent. Please confirm your consent by ticking one or more of the following:
Newsletters, Other Communications, Activities and Groups*

We may contact you to keep you informed about what is going on in our parish or elsewhere, including news, events, meetings, clubs, groups & activities. These communications may also sometimes appear on our church website or in printed or electronic form (including social media).We may send you material from a group your child attends or contact you about groups and activities suitable for children & families that you/your child may be interested participating in. We may sometimes work with similar groups in other parishes. Occasionally names and photos may appear in newsletters, bulletins or on websites, or social media.
I Would Like to Receive Communications by...*

EmailPhone (including text)Social Media
You can grant consent to all the purposes; one of the purposes or none of the purposes. Where you do not grant consent we will not be able to use your personal data; (so for example we may not be able to let you know about forthcoming services and events); except in certain limited situations, such as where required to do so by law or to protect members of the public from serious harm. You can withdraw or change your consent at any time by contacting us.
Parental Consent

I have read this form & give consent for my child to attend activities at, or as part of a group from, our church.
Signed, Parent/Guardian

Clear
Full Name

First NameLast Name
Date

MonthDayYear
Date
In line with GDPR, the data you provide on this form will be stored securely for a period of one year from the date of signature, after which it will be destroyed. It will not be passed to any third parties without your expressed consent, except in a medical emergency or where lawfully requested by police.
Thank you!

We look forward to welcoming you to Illuminate soon.
Should be Empty:

Hello!

Your Child

Parent/Guardian

Special permissions

Thank you!