1st Fintona BB Annual Consent & Registration Form
Please complete all sections to help us meet your child's specific needs. All information will be kept confidential.
BB Company
*
Name of child/young person
*
Known as
Date of birth (DOB)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
Address
*
Parent/Carer name
*
Relationship to child/young person
*
Parent/Carer best contact number
*
Please enter a valid phone number.
Format: 00000000000.
Parent/Carer email
*
example@example.com
Emergency contact name
*
Emergency contact relationship to child/young person
*
Emergency contact best contact number
*
Please enter a valid phone number.
Format: 00000000000.
Name of GP
GP contact number
Please enter a valid phone number.
Format: 00000000000.
Medical details of child/young person (medical conditions, special needs, allergies, dietary requirements, medication, or anything else helpful for leaders to know)
I will inform the leaders of any important changes to my child’s health, medication or needs and also of any changes to our address or to any of the contact details given above. In the event of illness or accident, having parental responsibility for the above named child, I give permission for first aid to be administered where considered necessary by a trained first aider, if available, or medical treatment to be administered by a suitably qualified medical practitioner. If I cannot be contacted and my child should require emergency hospital treatment, I authorise the leadership team to take my child to a suitable hospital. I understand that every effort will be made to contact me as soon as possible.
*
I agree
During the time your child is with us, photographs/video/media recordings may be taken which may be used by the BB Company, Church and/or BBNI for publications or marketing purposes, including in print and online. For this, we need your permission.
*
I agree
PARENTAL CONSENT
I give permission for my child to attend and to participate in the activities associated and organised by the BB Company named above.I confirm that the information provided is correct to the best of my knowledge and undertake to notify the leader in charge of any changes.
Signed
*
Print name
*
Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Submit Registration
Should be Empty: