Clone of LBC HBC Parent Registration and Consent

LBC HBC Parent Registration and Consent

Please complete this form as Parent/Guardian to register and provide your consent for your child(ren)
From “PIT to the PALACE” Limavady Baptist Church in conjunction with the Faith Mission Gospel Truck welcome you and your family to enjoy our annual Holiday Bible WEEK 27th-31st July 2026 from 6.30pm to 8.00pm held on the Limavady Central Primary School grounds in the Faith Mission Truck.

WHO CAN ATTEND?
Children entering Primary 1 in September 2026 and upwards are welcome.

THE PROGRAMME? Bible Lessons, Games, & Activities.

Registration is essential. Please register below.

For more information, please contact: Jason Cruise via E-Mail: jasoncruise@live.co.uk, OR Mob: +44 7593 920300.

Limavady Baptist & the Faith Mission run Children’s programmes in a safe, kind, and fun manner, where Children are welcomed in the name of Jesus and taught His ways from the Bible.

All appropriate safeguarding and safety measures will be in place throughout the week. Any information submitted through this registration form will only be seen by relevant safeguarded leaders for the purpose of helping us run a safe and well-organised Holiday Bible Week.

We will not share your information with anyone else.
This Registration/Consent form can accomodate information for up to 3 Children. If you require to register more please submit Registration/Consent for first 3 Children then open up another form and add additional Child(ren). Thank-you
Full Name of Parent/Guardian

First NameLast Name
Email Address of Parent/Guardian
example@example.com
Phone Number of Parent/Guardian
Please enter a valid phone number.Format: 000 0000 0000.
Back-up Phone for Parent/Guardian
Please enter a valid phone number.Format: 000 0000 0000.
1st Child's Full Name

First NameLast Name
1st Child's Date of Birth

MonthDayYear
Relationship of 1st Child to Parent/Guardian
1st Child's Allergies, Medical or Behavioural Conditions
2nd Child's Full Name

First NameLast Name
2nd Child's Date of Birth

MonthDayYear
Relationship of 2nd Child to Parent/Guardian
2nd Child's Allergies, Medical or Behavioural Conditions
3rd Child's Full Name

First NameLast Name
3rd Child's Date of Birth

MonthDayYear
Relationship of 3rd Child to Parent/Guardian
3rd Child's Allergies, Medical or Behavioural Conditions
I give my consent to attend the Holiday Bible Club
I give my consent to participate in all the activities of the HBC
I give my consent should the need arise for First Aid/Medical treatment to be given
I give my consent for any photographs/videos taken that these may be used for general church or Faith Mission purposes, website or Facebook
Parent Signature
Should be Empty: