Monday Club 2025-26

MONDAY CLUB IS NOW FULL. FILL IN THIS FORM TO PUT YOUR CHILD'S NAME ON THE WAITING LIST. If you have any questions, contact Anne Gunn on 07770720601 or anne@westsideyouthproject.co.uk

Name of child*

Date of birth*

dd/mm/yy

Address*

Class*

Any additional needs, allergies or medical conditions of which we should be aware?

Name of parent/carer*

Phone number of parent/carer*

E-mail of parent/carer

Alternative contact name (in case of emergencies)*

Alternative contact number*

I give permission for Kinmylies Church to contact me about future events. (Data will be stored securely and not passed on to any other parties. Our full data protection policy is available on the church website: www.kinmylies.co.uk/dataprotection.htm)*

YesNo

I give permission for photos and videos to be taken and displayed within the church and on the church Facebook page or YouTube channel. I give permission for photos and videos to be shared with our partners in Westside Youth Project for publicity purposes.*

YesNoDisplayed within the church but not online

I give permission for my child to take part in activities as outlined above. In an emergency and/or I cannot be contacted, I am willing for my child to receive necessary hospital or dental treatment including an anaesthetic.

Signature