Moneymore Presbyterian Church Holiday Bible Club Registration
Please complete one form for each child. If you have any questions, please email us (moneymorehbc@gmail.com). Registration will close on Sunday 8th August 2021. Thank you.
Child's Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
School year group going into in September 2021
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent / Guardian Information
Name
*
First Name
Last Name
Mobile Number
*
Email
*
example@example.com
Collection of Holiday Bible Club Pack for both virtual and in person events.
This year we will be creating a Holiday Bible Club pack with everything required for both in person and virtual events. Each child will receive an age appropriate pack (as indicated above). If you miss a day, your child can always create the craft and complete the activity sheets! These packs will be available from the church hall (Circular Road) on Wednesday 11th August 2021.
How would you like to receive your holiday bible club pack?
At the church hall
I would like it emailed to me
Registration for In-Person Events
Tuesday 17th and Thursday 19th August 2021 at 6:30 - 8pm at the Manse Garden.
Is your child planning on attending the in person events on Tuesday and/or Thursday evening?
*
Yes
No
What day / days is your child planning on attending?
Tuesday 17th August
Thursday 19th August
Please give details of any medical or dietary conditions (i.e. asthma, diabetes, allergies), additional needs or disability. This information will be treated confidentially.
Emergency Information
Please complete if your child is coming to the in person events.
Emergency Contact's Name 1
First Name
Last Name
Relationship
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Other
Mobile Number
Emergency Contact's Name 2
First Name
Last Name
Relationship
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Other
Mobile Number
Registration for Family Event
Friday 20th August at 6:30pm in the Manse Garden. You only need to fill this section out once if you have more than one child!
Do you and your family plan to attend the family event?
*
Yes, we will be there.
No, unfortunately we cannot come.
How many people from your family are planning on attending?
Please Select
2
3
4
5
6
7
8
9
10
Bring all your family!
Please provide the names of everyone in your family planning on attending for track and trace purposes.
Authorisation by Parent / Guardian
I (having parental responsibility for the above named person) give consent to any emergency medical treatment that may be necessary during the duration of the Holiday Bible Club.
*
Yes
No
Do you give permission for photos and videos to be used by the church i.e. on social media or during church services?
*
Yes
No
I give permission for the above-named child to attend the Moneymore Presbyterian Holiday Bible Club 2021 and can confirm that they will not attend if any member of the child's household has experienced COVID symptoms on, or after, the 6th August. I confirm that were symptoms do arise during the week commencing 16th August I will immediately withdraw the above-mentioned child and inform a Holiday Bible Club leader.
*
Yes
Data Protection
The information you have given us in this form is held and used throughout the Holiday Bible Club. We do not share information with any other organisations.
Can we contact you with reminders and information about next summer's activities and events?
*
Yes
No
If yes, how would you like to be contacted?
Mobile
Email
Either
My child is permitted to attend and participate in all the activities of this Holiday Bible Club.
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: