Backpackers 2019 Registration Form

Backpackers Holiday Bible Club 2019 Registration

HBC is available for children 5 years old to 11 years old.
How many children are you registering? *
Child Information
First Child
Child's Name *

First Name Last Name
Child's Birth Date *

Day Month Year
Gender *

Female Male
Does the child attend Sunday school or Messy Church anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Second Child
Child's Name *

First Name Last Name
Child's Birth Date *

Day Month Year
Gender *

Female Male
Does the child attend Sunday school anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Third Child
Child's Name *

First Name Last Name
Child's Birth Date *

Day Month Year
Gender *

Female Male
Does the child attend Sunday school anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Fourth Child
Child's Name *

First Name Last Name
Child's Birth Date *

Day Month Year
Gender *

Female Male
Does the child attend Sunday school anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Children's Compatibility
Are these children better kept together in a group or do they respond better separately? Are there other children registered that they would like / not like to be placed in a group with?
Child Release Information
Parent/Legal Guardian Name *

First Name Last Name
Mobile Phone Number *

Area Code Phone Number
Email *
example@example.com

Address *

Street Address
Street Address Line 2
City	County
Post Code	Country

Names of Persons to which the child (children) may be released to each night after HBC (Please provide at least two) *

First Name Last Name
Full Name *

First Name Last Name
Full Name

First Name Last Name
Full Name

First Name Last Name
Are there any persons to which the child (children) may NOT be released to? *

Yes No
Who may your child (children) NOT be released to?
Emergency Contact 1 (other than parent/guardian listed above) *

First Name Last Name
Emergency Contact 1 Phone Number *

Area Code Phone Number
GDPR
By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by the church in printed and/or electronic media, including the church's website and social media.

I Agree
By clicking the box below, I give permission for my contact details to be used after this event for the purposes of informing me of other events that might be of interest to me. * We will need to use your the details you have given to keep you up-to-date with information for this event, however we would also like to keep these details to contact you for future events. Your contact details will never be passed on to third-parties.

I Agree
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Backpackers Holiday Bible Club 2019 Registration

Child Information

First Child

Second Child

Third Child

Fourth Child

Children's Compatibility

Child Release Information

GDPR