Registration Form Kingdom Builders Holiday Club
Please complete this registration form for Kingdom Builders Holiday Club. Ensure all required details, medical information, and permissions are provided accurately.
Child Details
Child's Name
*
First Name
Last Name
Gender
M
F
Date of Birth
*
Primary Class in August 2026
*
Days Child Is Not Attending Holiday Club
Monday
Tuesday
Wednesday
Thursday
Friday
Parent or Guardian Details
Parent or guardian's name and address
*
Landline or mobile number
*
Email address
*
Emergency contact name and telephone number
*
Child's GP's name, address and telephone number
*
Declarations and Permissions
I confirm that the above details are complete and correct to the best of my knowledge
*
Yes
No
I give permission for first aid to be given by the nominated first-aider in the event of illness or accident
*
I give permission
I do not give permission
I give permission for hospital treatment including anaesthetic in an emergency if I cannot be contacted
*
I give permission
I do not give permission
Would you like to be informed of future church events?
*
Yes
No
I give permission for the child's photographs to be used in Greenbank online and printed publications
*
I give permission
I do not give permission
I give permission for the child's photographs to be used on Greenbank's social media pages
*
I give permission
I do not give permission
Submit
My Products
prev
next
( X )
Monday
£5.00
£
5.00
Tuesday
£5.00
£
5.00
Wednesday
£5.00
£
5.00
Thursday
£5.00
£
5.00
Friday
£5.00
£
5.00
Should be Empty: