ABC YOUTH CLUB Registration Form

Your privacy is important to us, and we want to communicate with those who attend the ABC YOUTH CLUB in a manner that aligns with their consent and complies with UK Data Protection laws. Due to a change in the law in 2018, we require your consent regarding how we contact you or your child. Please provide the contact details you would like us to use for communication.

CHILD INFORMATION

Full Name(Required)

Date of Birth(Required)

Gender

Male

Female

Prefer not to say

Home Address(Required)

Street Address City Postal Code

PARENT / GUARDIAN'S INFORMATION

Parent/Guardian Name(Required)

Home Phone(Required)

Work/Mobile Phone

Emergency Contact Name(Required)

Emergency Phone(Required)

Relationship to Child

Email(Required)

MEDICAL INFORMATION

Child’ s GP Name and Address(Required)

GP Phone Number(Required)

Known allergies or conditions ( or reply NONE)(Required)

I confirm that the above details are complete and correct to the best of my knowledge(Required)

Yes

In the event of i l lness or accident I give permission for first aid to be given by the nominated first-aider(Required)

Yes

In an emergency, and i f I cannot be contacted, I am willing for my child to be given hospital treatment, including anaesthetic(Required)

Yes

I give permission for my details and those of my child to be entered into the church database(Required)

Yes

I give permission for my child' s photographs to be used in Allington Baptist Church online and printed publications(Required)

Yes

I give permission for my child' s photographs to be used on Allington Baptist Church' s social media pages(Required)

Yes

I agree with the church contacting me by

Post

Phone

Text

Whats App

Tell me about Youth news, events, activities, Services at ABC

Parent Signature(Required)

Date