Cipher Registration Form

Thank you for registering to come to Cipher (Monday evenings 7 to 8.30pm during term time).

Please complete the information below.

We are collecting the information to enable us to contact the group outside of Mondays, for example as a reminder of an event or in the unlikely event of a cancellation. The information given will be kept securely in line with our Data Protection Policy – more details about this are given at the bottom of this form. Only the Cipher leaders will have access to this information.

Thanks!

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Child's name *
Child's date of birth *
MM
/
DD
/
YYYY
Address (including post code) *

Does the child have any allergies or medical conditions?

Parent/Guardian names
 *
Please indicate how they will get home at the end of the session
 *
Person to contact when the young person is with us on Monday evenings, in case of emergency
 *
Telephone number *
Alternative telephone number *

Privacy Policy:

Data Protection:  St Thomas’ Church is committed to protecting your privacy and will process your personal data in accordance with current Data Protection legislation.  The information we collect on this form is not used or released for any other purpose than running our groups.  A full data privacy statement is available on our website – www.stthomaskidsgrove.co.uk, or you can request a copy by emailing church@stthomaskidsgrove.co.uk.
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