Monday 25th January - 6:30-9:30pm
Hesketh Bank Christian Centre, Moss Lane, Hesketh Bank, PR4 6AA
Full Name
*
Church Name
*
Phone Number
*
-
Email
*
example@example.com
Are you over the age of 18 years?
*
Yes
No
Dietary Requirements
*
Gluten Intolerant/Coeliac
Lactose Intolerant
Nut allergy
Vegan
Vegetarian
No dietary requirements
Other
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The personal information obtained through the completion of this form will be used by members of the Gathering team to contact you with regards to the Gathering. We will not share your details with any third parties, unless with your permission.
*
Please tick to confirm that you have understood and agree to your information being used in this way
Do you give permission for us to retain your contact details so that members of The Gathering Team may contact you about future Gatherings and other youth events that maybe of interest to you?
*
Yes
No
If in future you wish to withdraw your consent please email youthministry@blackburn.anglican.org with the consent details you wish to have removed.
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