Homework Club P5 and P6 Sign Up 2024
This is a consent form for Homework Club at Ballysally Presbyterian Church from Feb 2024- April 2024. It is for all those in P5 and P6.
Child's Name
*
First Name
Last Name
Child's date of birth
*
Please select a day
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Day
Please select a month
January
February
March
April
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July
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September
October
November
December
Month
Please select a year
2026
2025
2024
2023
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1920
Year
Child's address
*
Street Address
Town
Post Code
Child's Class in school
*
Please Select
P5
P6
Parent/ Carer's Name
*
First Name
Last Name
Relationship to Child
*
Parent / Carer's phone number
*
undefined
Parent/ Carer's email
*
example@example.com
Second contact's name
*
First Name
Last Name
Second contact's phone number
*
undefined
Relationship to child
*
Doctor's Details (Name and health centre)
*
Any relevant medical details
Please indicate any medical conditions, medications being taken, or allergies that are relevant to your young person.
Please include details of any additional needs your young person has, or any extra support required to help us care for them well.
During the time your child will spend with us, photographs and videos may be taken for general church purposes and use on social media. Please indicate below if you give permission for photographs and videos to be taken of your child.
*
Yes, photos and videos may be taken of my young person
No, photos and videos may not be taken of my young person
I have filled out the information on this consent form to the best of my ability, and give consent for my child to participate in homework club at Ballysally Presbyterian Church during the 2024-25 school year.
Please sign name above
Submit
Should be Empty: