Thursday Bible Club Consent Form

Thursday Bible Club Booking & Consent Form
We are inviting parents and guardians to book their children into Thursday Bible Club for the 2025/2026 season. The club is for those who attend National School, we plan to have a Bible story, Quiz, Bible Verse, Music, Games and Occasional Crafts.
Parent's contact details will be used in a Whatsapp group to notify them of updates and reminders.

Parents should complete the form prior to the first day that their child(ren) attends club.

For more information contact:
Mervyn Tomb 0860575462/ Daniel Brown 0851720478
When: Alternate Thursday nights: 11 September, 25 September, 9 October, 23 October, 6 November, 20 November, 4 December, 18 December.
6.30-7.45pm

Where: The Parochial Hall, Mountrath

Who: For those at National School

How Much: This is a free club.
Name of Child #1*

First NameLast Name
Date of Birth #1*

DayMonthYear
Date
Name of Child #2

First NameLast Name
Date of Birth #2

DayMonthYear
Date
Name of Child #3

First NameLast Name
Date of Birth #3

DayMonthYear
Date
Address

Street Address

Street Address Line 2

CityCounty

Eircode
Parent's Email*

Confirmation Emailexample@example.com
Parent's Mobile Phone Number*
Emergency contact, if parent is unavailable*
Name and mobile number
Details of any known conditions, allergies (Eg asthma, diabetes epilepsy) and medications being taken
Any other special needs, requirements which we should know about.
Consent
I give permission for my data to be stored by the Faith Mission for notification of future events.*

Consent
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In the event of illness or accident, I give permission for first aid to be administered where considered necessary by a trained first aider, if available, or medical treatment to be administered by a suitable qualified medical practitioner.

If I cannot be contacted and my child should require emergency hospital treatment, I authorise an adult leader to sign on my behalf any written form of consent required by the hospital. However I understand that every effort will be made to contact me as soon as possible.
Consent to all the above
Signature

Clear
Parent or Guardian's Name*

First NameLast Name
Should be Empty:

Thursday Bible Club Booking & Consent Form

Consent