Children's Bible-Study Breakfast Club (CBBC)

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PLEASE SUBMIT ONE PER CHILD

Enrolment Fee: £2 per child
Contact Numbers: Dr Ebun Patrick 07828632390; 'Fola 07962204248

PRIVACY POLICY: By filling this form you consent to Love Assembly/ The Liverpool Ark Discovery Centre holding and processing your personal data. You can withdraw or change your consent at any time by contacting the Administrator at admin@loveassembly.co.uk. Please note that all processing of your personal data will cease once you have withdrawn consent, other than where this is required by law, but this will not affect any personal data that has already been processed prior to this point.

Please make payment via Bank transfer:
Account Name: The Liverpool Ark Discovery Centre
Sort Code: 010061
Account Number: 20698151
Bank name: NatWest Bank Plc

𝐑𝐞𝐟𝐞𝐫𝐞𝐧𝐜𝐞: 𝐂𝐂/𝐒𝐮𝐫𝐧𝐚𝐦𝐞

Or Pay at the Door

You can make payment for all your children at the same time

Child's Surname *

Child's Name *

Date of Birth (DD/MM) *

YYYY

Sex (Child) *

Male

Female

Parent/Carer's Name *

Mobile Number (Parent/Carer) *

Email (Parent/Carer) *

Emergency contact name *

Emergency contact mobile number *

This is a breakfast club. Breakfast meals will be served so, we need to know any allergies we need to be aware of and any particular food your child will not eat.

Any food allergies? *

Yes

Please state any allergies *

Details of any allergy reactions *

Photography, Filming, Publicity and Data Storage

I understand Love Assembly/ The Liverpool Ark Discovery Centre (The LADC) will not take any pictures or videos that are not necessary for this breakfast club. Love Assembly/ The LADC will also keep all its images in accordance with data protection law and delete the images that have not been used for any reasons for more than 3 years. I know I have the right to withdraw consent at any time by emailing admin@loveassembly.co.uk but understand that withdrawing consent may not affect the material that has already been used.

I give consent to Love Assembly/ The LADC to take and publish images and videos and use the name of my children on the website, instagram, facebook and youtube (www. loveassembly.org & www.theladc.co.uk)

Yes

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