HOLIDAY CLUB 2022  
Registration and Consent Form

Holiday Club is open to children who are in Reception through to Year 6 in July 2022.  Once all places have been filled, we will operate a waiting list.

Please complete one form for each child attending.
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Email *
Child's First Name *
Child's Family Name *
Date of Birth *
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Gender
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Address *
Name of parent / guardian / care giver *
Home Telephone Number *
Mobile number of parent / guardian / care giver *
Emergency contact details during holiday club if different from above
School attended in July 2022 *
Please indicate which days you would like to attend.  This is not binding but gives us an indication of numbers each day. *
Required
School Year Group in July 2022 *
Are there any friends your child would like to be in a group with?  Our groups are arranged broadly by school year.  We will do our best to take requests into account when planning groups but cannot guarantee all requests, as this will be dependent on numbers.
Does your child have any allergies / medical conditions / additional needs that holiday club leaders need to be aware of or that would help holiday club leaders care for your child? Please give details below.
GP Name and Contact Number *
I give permission for my child to attend the St John's Holiday Club 2022 *
I give permission for my child to be included in photographs taken during holiday club.  These will be used for internal church purposes only, including displaying during the Holiday Club service on Sunday 31st July. *
In the unlikely event of illness or accident I give permission for the any appropriate first aid to be given by the nominated first aider.   *
In an emergency, and If I cannot be contacted, I am willing for my child to be given any hospital treatment, including anaesthetic, if necessary.  I understand that every effort will be made to contact me as soon as possible. *
The information given above will be held on file for the duration of holiday club.  Do you give permission for your contact details to be retained after holiday club so we can contact you with details of other activities we may run for children?
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