IMPACT WEEK EVENT REGISTRATION
Welcome to Impact Summer Registration!We’re excited to have your child/young person join us for a brilliant week of fun, faith, and community at Kilfennan. This form covers all our children’s and youth events during Impact Week: IMPACT Tots (Parent & Toddler Holiday Bible Club – Thursday 30th July, 10.30am-12pm . Holiday Bible Club (P1–P7) – Monday 27th to Friday 31st July (Mornings 10.30am-12pm). Teens Evenings – Tuesday 28th to Friday 31st July (7.30-9pm) Please complete one form for child/young person (space for up to 4 Kids) .We can’t wait to see everyone this summer as we learn, play, and grow together.
Parent / Guardian Details
Name of Parent/Guardian
*
First Name
Last Name
Relation to Child
*
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
County
Post Code
Secondary Emergency Contact
*
First Name
Last Name
Relation to Child
*
Phone Number
*
-
Area Code
Phone Number
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Next
Child 1 Registration
Name
*
First Name
Last Name
Event Attending
Impact Tots (Thursday 30 July)
Impact Kids (Monday 27 - Friday 31 July)
Impact Teens (Tuesday 28-Friday 31 July)
Name usually known by
*
Date of Birth
*
-
Day
-
Month
Year
Date
School Year (P1-7)
*
Medical/Additional Needs
Please list any medical conditions, allergies, dietary requirements, additional needs, or medication being taken.
*
Anything else that would be helpful for leaders to know?
*
In the event of illness or accident, do you give permission for first aid to be administered by a trained first aider (if available) or for medical treatment to be given by a qualified medical practitioner?
*
Yes
No
Photography Permissions
Do you give permission for photographs/video of your child to be taken and used for church purposes (e.g., PowerPoint in services)?
*
Yes
No
Do you give permission for photographs/video of your child to be posted on the church website or church Facebook page/group?
*
Yes
No
Do you wish to register another child?
Yes
No
Back
Next
Child 2 Registration
Name
First Name
Last Name
Event Attending
Impact Tots (Thursday 30 July)
Impact Kids (Monday 27 - Friday 31 July)
Impact Teens (Tuesday 28-Friday 31 July)
Name usually known by
Date of Birth
-
Day
-
Month
Year
Date
School Year (P1-7)
Medical/Additional Needs
Please list any medical conditions, allergies, dietary requirements, additional needs, or medication being taken.
Anything else that would be helpful for leaders to know?
In the event of illness or accident, do you give permission for first aid to be administered by a trained first aider (if available) or for medical treatment to be given by a qualified medical practitioner?
Yes
No
Photography Permissions
Do you give permission for photographs/video of your child to be taken and used for church purposes (e.g., PowerPoint in services)?
Yes
No
Do you give permission for photographs/video of your child to be posted on the church website or church Facebook page/group?
Yes
No
Do you wish to register another child?
Yes
No
Back
Next
Child 3 Registration
Name
First Name
Last Name
Event Attending
Impact Tots (Thursday 30 July)
Impact Kids (Monday 27 - Friday 31 July)
Impact Teens (Tuesday 28-Friday 31 July)
Name usually known by
Date of Birth
-
Day
-
Month
Year
Date
School Year (P1-7)
Medical/Additional Needs
Please list any medical conditions, allergies, dietary requirements, additional needs, or medication being taken.
Anything else that would be helpful for leaders to know?
In the event of illness or accident, do you give permission for first aid to be administered by a trained first aider (if available) or for medical treatment to be given by a qualified medical practitioner?
Yes
No
Photography Permissions
Do you give permission for photographs/video of your child to be taken and used for church purposes (e.g., PowerPoint in services)?
Yes
No
Do you give permission for photographs/video of your child to be posted on the church website or church Facebook page/group?
Yes
No
Do you wish to register another child?
Yes
No
Back
Next
Child 4 Registration
Name
First Name
Last Name
Event Attending
Impact Tots (Thursday 30 July)
Impact Kids (Monday 27 - Friday 31 July)
Impact Teens (Tuesday 28-Friday 31 July)
Name usually known by
Date of Birth
-
Day
-
Month
Year
Date
School Year (P1-7)
Medical/Additional Needs
Please list any medical conditions, allergies, dietary requirements, additional needs, or medication being taken.
Anything else that would be helpful for leaders to know?
In the event of illness or accident, do you give permission for first aid to be administered by a trained first aider (if available) or for medical treatment to be given by a qualified medical practitioner?
Yes
No
Photography Permissions
Do you give permission for photographs/video of your child to be taken and used for church purposes (e.g., PowerPoint in services)?
Yes
No
Do you give permission for photographs/video of your child to be posted on the church website or church Facebook page/group?
Yes
No
Back
Next
Parent/Guardian Confirmation
I confirm that the information provided is accurate and I will inform leaders of any changes to my child’s health, medication, needs, address, or contact numbers.
*
Yes
Name
*
First Name
Last Name
Date
*
-
Day
-
Month
Year
Date
Submit
Should be Empty: