Wanted in the Wild West Holiday Club Sign-up form
Mosspark Baptist Church Summer Holiday Club - Apri 13th-17th, 10.30am-12.30pm
Child's name
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First Name
Last Name
School
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Primary
*
Please Select
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Date of birth
Parent/ Guardian name
*
First Name
Last Name
Phone number
*
Email address
*
example@example.com
Does your child have any medical conditions? If yes, please detail below.
Does your child have any dietary requirements? If yes, please detail below.
I consent to the use of my child's photo being used on future social media posts and publications
*
Yes
No
For group activities, is there a specific friend your child would like to be grouped with who is also attending? If yes, please specify their name below. We will try our best to make this possible, however, depending on numbers it may not be possible.
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