Polar Explorers' Holiday Bible Club

Polar Explorers' Holiday Bible Club

Child Registration Form
Thank you for your interest in this year's Holiday Bible Club at Legacurry. You've taken your first step to becoming a Polar Explorer!

As we'll be asking you for some information as part of this process, we first of all need to tell you some things to comply with GDPR regulations.

We, Legacurry Presbyterian Church, are the data controller for the purposes of data protection legislation.
We require the following information from you to allow us to register your child for Holiday Bible Club. We are collecting this information to enable the church to run the event safely, allow for protection of your interests in respect of dietary and medical requirements, and to ensure we can contact you (or other nominated adult) in case of an emergency. Data Protection legislation allows us to process this information as we regard it as being in the church’s legitimate interest. If you are unable to supply the information requested then we will be unable to accept your participation. We encourage parents and children to discuss the importance of personal data protection – a child for data protection purposes in the UK is under 13 (under 16 in RoI).
Child Registration & Consent Form

This form should be completed by a Parent or Guardian. Please complete one form for every child attending Polar Explorers.
What is your child's name?

First NameLast Name
What is your address?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How old is your child?
What Primary School class (P1-P7) has the child just finished ?
What is the name of the Parent or Guardian to be contacted?
What is the email contact for this Parent or Guardian? We will send an email confirmation of our receipt of this form to this email address.
example@example.com
What is the daytime contact number for this Parent or Guardian?

Area CodePhone Number
Who is the Emergency Contact if this Parent or Guardian cannot be reached?
What is the daytime contact number for the Emergency Contact?

Area CodePhone Number
Does this child have any special dietary requirements? Please list below.
Does this child have any medical information e.g. allergies, that you need to tell us?
In the event of illness or accident, having parental responsibility for the child named above, 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.
Please click 'I agree' to confirm your consent to the above.

I agree
If I cannot be contacted and my child should require emergency hospital treatment, I authorise an adult leader to sign, on my behalf, a written form of consent required by the hospital. However, I understand that every effort will be made to contact me as soon as possible.
Please click 'I agree' to confirm your consent to the above.

I agree
During the time your child will spend with us, photographs may be taken for general church purposes or for church social media. For this we need your permission.
I give permission for such photographs / video to be used for purposes within Legacurry Presbyterian Church.

YesNo
I give permission for such photographs / video to be posted on the Legacurry Presbyterian Church website and Social Media (Facebook) page.

YesNo
I confirm that the above details are correct to the best of my knowledge.
Signature of Parent or Guardian
Please press submit to send this form to Legacurry Presbyterian Church.

Please note you will be required to physically sign this form at the start of the first day this child attends Polar Explorers.

The form will be pre-printed by us so you do not need to bring along a copy.

For more information on holiday bible club, please contact Michelle Thompson on 07743431312 or Emma McCoosh on 07516300242.

We look forward very much to seeing you at
Polar Explorers!

You can withdraw consent at any time by contacting the church's Clerk of Session

John Ferguson by email: ferguson478@btinternet.com.
Legacurry Presbyterian Church is a Registered Charity in Northern Ireland (NIC105293)
Should be Empty:

Polar Explorers' Holiday Bible Club

Child Registration & Consent Form