Registration Form

Christmas Event for Children
2pm–5pm on Sunday 8th December, 2024

You can register up to three children using this form.
The children must all live in the same household.
When registering a child, all the fields for that child must be completed.
Where fewer than three children are being registered, leave all subsequent children's fields blank.

1st Child's Name *

1st Child's Gender

1st Child's date of birth *

1st Child's Primary Class in August 2024 *

1st Child: Any known allergies or conditions? *

2nd Child's Name

2nd Child's Gender

2nd Child's Date of Birth

2nd Child's Primary Class in August 2024

2nd Child: Any known allergies or conditions?

3rd Child's Name

3rd Child's Gender

3rd Child's Date of Birth

3rd Child's Primary Class in August 2024

3rd Child: Any known allergies or conditions?

Parent/Guardian's Name and Address *

Tel or Mob Number *

Email address *

Emergency Contact (Name & Number) *

Children's GP's Name, Address and Telephone Number *

I confirm that the above details are complete and correct to the best of my knowledge *

Yes

In the event of illness or accident I give permission for first aid to be given by the nominated first-aider. In an emergency, and if I cannot be contacted, I am willing for my children to be given hospital treatment, including anaesthetic *

I give permission

I do not give permission

I give permission for my details and those of my children to be entered into the church database *

I give permission

I do not give permission

I give permission for my children's photographs to be used in Greenbank online and printed publications *

I give permission

I do not give permission

I give permission for my children's photographs to be used on Greenbank's social media pages *

I give permission

I do not give permission

I give permission for my children's photographs to be used during a church service, to share with the congregation some of the activities they’ve been involved in *

I give permission

I do not give permission

Would you like to be informed about future events for children at Greenbank Church?

Yes

How did you hear about the Greenbank Christmas event for Children?

In Greenbank weekly e-newsletter

In Greenbank Connections newsletter

Poster in Church premises or elsewhere

Flyer brought home from School

From an organisation meeting at Greenbank

By word of mouth

Other

* Required Fields

Registration Form

Christmas Event for Children 2pm–5pm on Sunday 8th December, 2024

Christmas Event for Children
2pm–5pm on Sunday 8th December, 2024