Holiday Club Registration Form Oct 24

Holiday Club Registration Form

Please answer the following questions to register your child for the Winslow Christian Fellowship Holiday Club at Sir Thomas Fremantle School, 10am-12 on Monday 28th, Tuesday 29th and Wednesday 30th of October
Child's name

First NameLast Name
Child's Date of Birth

DayMonthYear
Date
Please tick each date that your child will attend

Monday 28th OctoberTuesday 29th OctoberWednesday 30th October
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Parent/carer

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name of back up contact (in case primary contact is unavailable)

First NameLast Name
Back Up Contact Phone Number

Area CodePhone Number
Details of any medication or medical issues (e.g. asthma, epilepsy, diabetes, allergies, dietary needs, learning difficulties or neurodiversity)
Sometimes we take photos or videos of activities to use in a presentations, leaflets or our website. Do you give permission for us to use images taken during Mega Makers that may include your child?

YesNo
Does your child have any allergies to food/colourings/additives in the use of cooking? If we were to do cooking as an activity would there be a problem with this?

YesNo
In the unlikely event of illness or accident, I give my permission for any necessary medical treatment to be given. In an emergency and I am not contactable, I am willing for my child to receive hospital treatment, including an anaesthetic. I understand that every effort will be made to contact me as soon as possible.

I agree
If you want to register another child you will have the option after submitting this form.

It is the responsibility of the parent/carer to take their child to and from Mega Makers. I confirm that the details above are correct to the best of my knowledge.

Winslow Christian Fellowship operates a Child Protection Policy. Please speak to one of the leaders if you require more information. The information provided in this form will be used solely for dealing with your child while they are attending Mega Makers. WCF has a Data Protection Policy which can be found on the WCF website and all information held will be stored and dealt with in accordance with this policy
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