Use this form to register your child for
 Greenbank's Messy Church

on Saturday, 3 February 2017, 4pm–6pm


Number of people (children and adults) who will at:*
Full name(s) of children attending Messy Church:*
Parent/Guardian's name and address:*
Parent/Guardian's email address:*
Telephone Number:
School Year(s) i.e. P1, P2, etc.:*
I give permission for my details and those of my child/children to be entered into the church database:*
I give permission for my child/children's photographs to be used in Greenbank online and printed publications:*
Please enter the verification number on the right:*
one two two two six
* Required Fields